Broadnax, Jerriod Nicholas

Broadnax, Jerriod Nicholas is an sole proprietor health care provider with primary practice located at 509 E. Milsap Road Suite 9, Fayetteville AR 72703. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional, Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Broadnax, Jerriod Nicholas can be contacted via phone (479) 879-7038.

Contact Information

Primary practice address
509 E. Milsap Road Suite 9 Fayetteville AR 72703
Phone: (479) 879-7038
Fax: (479) 340-0500
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 28533 Indiana
Behavioral Health & Social Service Providers / Professional 101YP2500X 016701 Virginia
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 333L Arkansas

Profile Details

NPI number 1427116581
LBN Legal business name Broadnax, Jerriod Nicholas
Credentials LADAC, NCAC-II, CFC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 4th, 2006
Last updated Aug 10th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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