Broadwater, Denise Ann
Broadwater, Denise Ann is an sole proprietor health care provider with primary practice located at 105 Commons Way , Greenville SC 29611-3850. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Broadwater, Denise Ann can be contacted via phone (864) 520-2020.Contact Information
Primary practice address
105 Commons Way
Greenville SC 29611-3850
Phone: (864) 520-2020
Fax: (864) 640-4400
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 5164 | South Carolina |
Profile Details
| NPI number | 1750562112 |
|---|---|
| LBN Legal business name | Broadwater, Denise Ann |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 14th, 2007 |
| Last updated | Oct 6th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750562112 | NPPES |
| South Carolina | MEDICAID | 322842 SC | |
| South Carolina | Other | 5164 |
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