MRS. JENNY LEE BROADDUS (NPI# 1336644582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336644582 |
| Entity Type | Individual |
| Full Name | MRS. JENNY LEE BROADDUS |
| Other Name | JENNY LEE FULLER |
| Credential | LPC-S |
| Practice Address |
8150 N. Major Dr. Beaumont TX 77706 |
| Mailing Address |
3160 Brownstone Pl Beaumont TX 77706-7449 |
| Practice Telephone | 4098980702 |
| Mailing Telephone | 4095042545 |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
58968 | TX | Behavioral Health & Social Service Providers |
| Street Address |
8150 N. MAJOR DR. |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417567934 | Cassandra Covington Dewall | Counselor | 8150 N. Major Dr., Beaumont, TX 77713 | 2020-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982176293 | Allen Family Home Care LLC | In Home Supportive Care | 4055 Dowlen Rd Ste 112, Beaumont, TX 77706 | 2018-12-27 |
| 1730661174 | Joseph Pryor Ingram | Counselor | 5450 Folsom Road #3, Beaumont, TX 77706 | 2018-09-02 |
| 1528584026 | Amanthia Peace Williams | Pedorthist | 3645 Calder Ave., Beaumont, TX 77706 | 2017-08-16 |
| 1356863286 | Nicole Denise Williams | Speech-Language Pathologist | 970 North 23rd Street, Beaumont, TX 77706 | 2017-07-12 |
| 1487038923 | Associates for Dental Health, Pllc | Dentist | 415 Dowlen Rd Ste A, Beaumont, TX 77706 | 2015-07-15 |
| 1508264532 | Rose Anne Essex | Dietitian, Registered | 3510 Charleston Ln, Beaumont, TX 77706 | 2014-12-08 |
| 1780001933 | C. Asteris, Inc. | Contractor | 1465 W. Lucas Dr., Beaumont, TX 77706 | 2014-03-26 |
| 1376985820 | Erica J Hayes M D P A | Preferred Provider Organization | 4a Bayou Brandt Drive, Beaumont, TX 77706 | 2013-07-25 |
| 1194162909 | Hezron Omanga | Pharmacist | 3585 N. Dowlen Road, Beaumont, TX 77706 | 2013-06-03 |
| 1144666942 | Ida Lee Duplechin | Counselor | 6755 Phelan Boulevard, Bldg 24 Suite D, Beaumont, TX 77706 | 2013-05-20 |
| Find all providers in zip 77706 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144827460 | George Edward Hartsfield | Counselor | 7905 Silverleaf St, Beaumont, TX 77707-3624 | 2020-10-09 |
| 1811500218 | Simon Counseling and Consultation Associates Pa | Counselor | 990 Ih 10 N Ste 143, Beaumont, TX 77702-1051 | 2020-08-25 |
| 1275150930 | Lucas Acy Edd | Counselor | 8295 Washington Blvd, Beaumont, TX 77707-4732 | 2020-06-29 |
| 1962053405 | Lionheart Counseling LLC | Counselor | 4332 Willow Bend Ct, Beaumont, TX 77707-5405 | 2019-09-26 |
| 1629622865 | Sonja Hebert | Counselor | 3980 N Major Dr Apt 1222, Beaumont, TX 77713-4203 | 2019-07-25 |
| 1619432143 | Crissa Jean Vallery | Counselor | 2895 S 8th St Bldg F, Beaumont, TX 77701-7722 | 2019-02-08 |
| 1821567090 | New Beginnings Counseling Team. Pllc | Counselor | 3160 Fannin St Ste 108, Beaumont, TX 77701-3947 | 2018-11-17 |
| 1861985046 | Carla Coyte Badgett | Counselor | 4750 Dunleith St, Beaumont, TX 77706-7704 | 2018-06-12 |
| 1528555000 | Abbi Jones | Counselor | 8180 Willow Bend Dr Apt A, Beaumont, TX 77707-5145 | 2018-04-19 |
| 1396249199 | Crystal Bagby | Counselor | 2895 S 8th St, Beaumont, TX 77701-7722 | 2018-03-19 |
| Find all providers in BEAUMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.