Organization
BROADUS INTERNATIONAL GROUP NETWORK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATESHA BROADUS (CEO/FOUNDER)
(240) 447-2505
Entity
Organization
Contact information
Practice address
110 COLISEUM CROSSING, #5050, HAMPTON, VA 23666-5971
(757) 785-4424
(757) 785-4424
Mailing address
110 COLISEUM XING # 5050, HAMPTON, VA 23666-5971
(757) 778-9800
(757) 778-9899
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
—
106H00000X
Marriage & Family Therapist
—
—
106S00000X
Behavior Technician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
S6963161
VA
Other
Enumeration date
09/03/2017
Last updated
11/03/2023
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