Kelly Broadfoot, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

4258 Issued in AL

Practice address

1909 Commerce Ave
Cullman, AL 35055-6151

Phone

(256) 734-4688

NPI assigned

Feb 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Phoenix Counseling and Resources, LLC

  • Community/Behavioral Health Agency
  • Florence, AL
  • NPI 1144839408
  NPD (past)
• Southern Wellness Services

  • Community/Behavioral Health Agency
  • Florence, AL
  • NPI 1356880207
  NPD (past)

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1962942607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 COMMERCE AVE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350556151",
            "telephone_number": "256-734-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 COMMERCE AVE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350556151",
            "telephone_number": "256-734-4688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1128 Bradshaw Dr",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "AL",
            "postal_code": "356301438",
            "country_code": "US",
            "telephone_number": "256-762-4890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROADFOOT",
        "first_name": "KELLY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "C2826A",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AL",
            "license": "4258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah W Brickell, ED.S,NCC,RPTS, LPCS
• Andra Katie Bright, PMHNP
• John E Briscoe Jr., D.M.D.
• Erin Dulaney Britt, DO
• Janelle Britt
• Sileah Brock, CPM
• Nichole C Brooks, CRNP
• Stacy Brooks
• Amber S Brown
• Madison Brown, LICSW

• Counselor in Cullman, AL
• Providers in Cullman, AL by specialty
• Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.