Sonya Broadbent
Individual provider Active NPI Social Worker · Manistee, MI
NPI 1801344700 · NPPES record last updated Nov 20, 2019
Key facts
- NPI
- 1801344700
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6801102330 (MI)
- Practice address
- 310 Glocheski Dr
Manistee, MI 49660-2639 - Phone
- (877) 398-2013
- NPI assigned
- Sep 20, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801102330 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801102330 | MI | Yes |
Addresses
Primary practice location
310 Glocheski Dr
Manistee, MI 49660-2639
Mailing address
310 Glocheski Dr
Manistee, MI 49660-2639
Phone (877) 398-2013
Other providers in Manistee, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.