Broussard, Sandra S
Broussard, Sandra S is an individual health care provider with primary practice located at 2790 N Academy Blvd Ste 206, Colorado Springs CO 80917. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Broussard, Sandra S can be contacted via phone (719) 596-1530.Contact Information
Primary practice address
2790 N Academy Blvd Ste 206
Colorado Springs CO 80917
Phone: (719) 596-1530
Fax: (719) 559-1130
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 989473 | Colorado |
Profile Details
| NPI number | 1891822151 |
|---|---|
| LBN Legal business name | Broussard, Sandra S |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1891822151 | NPPES |
| Colorado | MEDICAID | 076866 |
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