Broadnax, Kim
Broadnax, Kim is an individual health care provider with primary practice located at 925 Keynote Cir Ste 300 , Brooklyn Hts OH 44131-1869. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Broadnax, Kim can be contacted via phone (216) 931-1400.Contact Information
Primary practice address
925 Keynote Cir Ste 300
Brooklyn Hts OH 44131-1869
Phone: (216) 931-1400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I.0005832 | Ohio |
Profile Details
| NPI number | 1417411018 |
|---|---|
| LBN Legal business name | Broadnax, Kim |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 28th, 2019 |
| Last updated | Jan 28th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417411018 | NPPES |
| Ohio | Other | 1972553063 | NPI |
| Ohio | MEDICAID | 9072202 | NPI |
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