Brogdon, Williba

Brogdon, Williba is an individual health care provider with primary practice located at 730 Broad St C, Sumter SC 29150-3356. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Contractor, Other Service Providers / Community Health Worker, Other Service Providers / Peer Specialist. Other Service Providers / Case Manager/Care Coordinator is her primary health care specialty. Brogdon, Williba can be contacted via phone (704) 701-0836.

Contact Information

Primary practice address
730 Broad St C Sumter SC 29150-3356
Phone: (704) 701-0836
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Contractor 171W00000X
Other Service Providers / Community Health Worker 172V00000X
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1467820803
LBN Legal business name Brogdon, Williba
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2015
Last updated Sep 2nd, 2015 - about 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1467820803 NPPES
South Carolina Other 000-000-0000 TARGETED CASE MANAGEMENT SERVICES

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