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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