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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750562112 NPPES
South Carolina MEDICAID 322842 SC
South Carolina Other 5164

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