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Organization

BROADDUS EMPOWERMENT LLC

Active
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Organization

BROADDUS EMPOWERMENT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBBIN GARRETT (OWNER)
(813) 475-0847
Entity
Organization

Contact information

Practice address
2101 E 142ND AVE APT 102, TAMPA, FL 33613-3629
(215) 876-2802
Mailing address
2101 E 142ND AVE APT 102, TAMPA, FL 33613-3629
(215) 876-2802

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TA0400X
Addiction (Substance Use Disorder) Psychologist
103TA0700X
Adult Development & Aging Psychologist
103TC2200X
Clinical Child & Adolescent Psychologist
133NN1002X
Nutrition Education Nutritionist
171M00000X
Case Manager/Care Coordinator
251300000X
Local Education Agency (LEA)
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center
324500000X
Substance Abuse Rehabilitation Facility
3245S0500X
Children's Substance Abuse Rehabilitation Facility
342000000X
Transportation Network Company

Other

Enumeration date
10/24/2023
Last updated
10/24/2023
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