MEDICARE: UNBROKEN CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427760289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNBROKEN CLINIC LLC

Provider Business Mailing Address
First Line	:	101 MISTY FOREST DR
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36869-3492
Country	:	US
Telephone Number	:	229-460-2361
Fax Number	:	706-287-1124

Provider Business Practice Location Address
First Line	:	823 VETERANS PKWY
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-2803
Country	:	US
Telephone Number	:	706-992-6000
Fax Number	:	706-287-1124

Authorized Official
Title or Position	:	OWNER/EMPLOYEE
Name	:	MRS. CARRIE PLAYER SEXTON
Credential	:	MS. MA, BS
Telephone Number	:	334-545-7136

Provider Enumeration Date	:	12/22/2022
Last Update Date	:	11/03/2025

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Directions to “UNBROKEN CLINIC LLC ” Practice Location

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