MS. KELLEY J. BROADAWAY LPC NPI 1164509642

NPI Information

NPI: 1164509642
Provider Name: MS. KELLEY J. BROADAWAY, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
5225 N LAMAR BLVD
AUSTIN, TX
ZIP 78751
Phone: (512) 483-5811
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MS. Kelley J. Broadaway, LPC is a professional counselor in Austin, TX. MS. Kelley J. Broadaway, LPC NPI is 1164509642. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5225 N LAMAR BLVD
AUSTIN, TX
ZIP 78751-820
Phone: (512) 483-5811
Fax: (512) 483-5828

The enumeration date for this NPI number is 11/1/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	11975	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	80886L	OTHER	TEXAS	BCBS (TEXAS)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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