Kelly Broyles, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT001514 Issued in GA

Practice address

2200 N Patterson St
Suite D
Valdosta, GA 31602-2597

Phone

(229) 244-1707

NPI assigned

Nov 8, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Choices for Life of Georgia, LLC

  • Community/Behavioral Health Agency
  • Valdosta, GA
  • NPI 1841328960
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1639611643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N PATTERSON ST",
            "address_2": "SUITE D",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022597",
            "telephone_number": "229-244-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N PATTERSON ST",
            "address_2": "SUITE D",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022597",
            "telephone_number": "229-244-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROYLES",
        "first_name": "KELLY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew R Brown, MD
• Norma Ann Brown, RN
• Sharonda Cheri Brown, FNP
• Tiffany Brown
• Kim Brownlee
• Kalyn Brumbley, LMFT
• Amanda Brunetto, FNP
• Chiquita Bryant, LPC
• Kierra Bryant
• Sarah Elizabeth Bryant, MED, CCC-SLP

• Marriage & Family Therapist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.