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Organization

BROADSTREET COUNSELING SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRANDON HAYGOOD LCSW (THERAPIST)
(313) 704-4217
Entity
Organization

Contact information

Practice address
2919 TELEGRAPH AVE APT 303, OAKLAND, CA 94609-3577
(313) 704-4217
Mailing address
2919 TELEGRAPH AVE APT 303, OAKLAND, CA 94609-3577
(313) 704-4217

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
Primary

Other

Enumeration date
11/14/2022
Last updated
11/14/2022
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