Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JERRIOD NICHOLAS BROADNAX, LADAC, NCAC-II, CFC
Active Sole ProprietorAddiction (Substance Use Disorder) Counselor · FAYETTEVILLE, AR
Registration Details
- NPI Number
- 1427116581
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 4, 2006 (19.381343357181 yrs)
- Last Updated
- Aug 10, 2021
- Licenses
-
28533 (IN)016701 (VA)333L (AR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
509 E. MILSAP ROADSUITE 9FAYETTEVILLE, AR, 72703Browse AR providers · Browse ZIP 72703
- Phone
- 4798797038
- Fax
- 4793400500
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
- Additional Specialty
- Professional Counselor
- Additional Specialty
- Case Manager
- Additional Specialty
- Addiction (Substance Use Disorder) Counselor
Other Addiction (Substance Use Disorder) Counselor Providers in FAYETTEVILLE, AR
| Name | Credential | NPI |
|---|---|---|
| JOHN M. LEIMER | MS, CSAC | 1962418095 |
| MISS KAREN HOWELL SUE HOWELL | LPC | 1376626424 |
| MS. AMANDA MICHELLE RIDDLE | CADC | 1528358975 |
| KATHY BAIN COLEMAN | MS | 1841561685 |
| MR. SCOTT MASHBURN | — | 1710564455 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.