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General NPI Number Information
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NPI Number | 1023676913
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Entity Type | Organization
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Legal Business Name | BROADRIGHT COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 1403 FANTAIL LANE FANTAIL LANE
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City | ENNIS
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State | TX
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Zip | 75119-6968
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Country | US
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Telephone | 719-685-6729
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Fax |
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Provider Business Mailing Address
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Address Line | 1403 FANTAIL LANE FANTAIL LANE
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City | ENNIS
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State | TX
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Zip | 75119-6968
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Country | US
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Telephone | 719-685-6729
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | TRISHA DANIELLE BROADRIGHT
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Credential | MA, LPC
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Telephone | 719-685-6729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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