| Mr Broderick Webster Sr, LPC | |
|
793 Tennessee St, Bolivar, TN 38008-2441 | |
| (731) 228-9068 | |
| (901) 425-9773 |
| Full Name | Mr Broderick Webster Sr |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 793 Tennessee St, Bolivar, Tennessee |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124897996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Broderick Webster Sr, LPC 844 Sheridan St, Memphis, TN 38107-4611 Ph: (901) 620-7289 | Mr Broderick Webster Sr, LPC 793 Tennessee St, Bolivar, TN 38008-2441 Ph: (731) 228-9068 |
Marvin Gary Gill, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 10710 Old Highway 64, Bolivar, TN 38008 Phone: 731-658-6113 Fax: 731-658-6165 | |
Harlis Reese, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 10710 Old Highway 64, Bolivar, TN 38008 Phone: 731-658-6113 Fax: 731-658-6165 | |
Michelle Guia, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 10710 Old Highway 64, Bolivar, TN 38008 Phone: 731-658-6113 Fax: 731-658-6165 | |
Lafonda Boyd, BLS Counselor Medicare: Not Enrolled in Medicare Practice Location: 10710 Old Highway 64, Bolivar, TN 38008 Phone: 731-658-6113 Fax: 731-658-6165 | |
Edward Daniel Hamer, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 10710 Old Highway 64, Bolivar, TN 38008 Phone: 731-658-6113 Fax: 731-658-1597 | |
Jacob Isaac Latham, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 10710 Old Highway 64, Bolivar, TN 38008 Phone: 731-658-6113 Fax: 731-658-6165 |