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MR. TRAVIS DEONTA BROADDUS NPI 1851015077


NPI Information

NPI: 1851015077
Provider Name: MR. TRAVIS DEONTA BROADDUS
Classification: Case Manager/Care Coordinator - 171M00000X
Entity Type: Individual
Address:
7135 MINSTREL WAY STE 204-M2
COLUMBIA, MD
ZIP 21045
Phone: (301) 357-0038
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MR. Travis Deonta Broaddus is a case manager care coordinator in Columbia, MD. The provider is a person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. MR. Travis Deonta Broaddus NPI is 1851015077. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7135 MINSTREL WAY STE 204-M2
COLUMBIA, MD
ZIP 21045-255
Phone: (301) 357-0038

The enumeration date for this NPI number is 9/30/2022 and was last updated on 5/8/2023.


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
1101YM0800XCounselorMental HealthNo
21041C0700XSocial WorkerClinicalNo
3106S00000XBehavior TechnicianNo
4171M00000XCase Manager/Care CoordinatorYes

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.