MRS. JACQUELINE BROADWAY LCMHC LCAS NPI 1861913097

NPI Information

NPI: 1861913097
Provider Name: MRS. JACQUELINE BROADWAY, LCMHC, LCAS
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
5919 OLEANDER DR STE 121
WILMINGTON, NC
ZIP 28403
Phone: (910) 210-6160
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MRS. Jacqueline Broadway, LCMHC, LCAS is a mental health counselor in Wilmington, NC. MRS. Jacqueline Broadway, LCMHC, LCAS NPI is 1861913097. 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:

5919 OLEANDER DR STE 121
WILMINGTON, NC
ZIP 28403-757
Phone: (910) 210-6160

The NPI 1861913097 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 6/28/2017 and was last updated on 9/20/2021.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LCAS-23554	NORTH CAROLINA	No
2	101YM0800X	Counselor	Mental Health	13518	NORTH CAROLINA	Yes

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: 4/28/2024

NPI Synchronization or Removal

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