Mr Travis Deonta Broaddus, in Columbia, MD - Case Manager/Care Coordinator

Mr Travis Deonta Broaddus, - Counselor in Columbia, MD

Mr Travis Deonta Broaddus, is a Case Manager/care Coordinator based in Columbia, Maryland. Mr Travis Deonta Broaddus is licensed to practice in * (Not Available) (license number ) and his current practice location is 7135 Minstrel Way Ste 204-m2, Columbia, Maryland. He can be reached at his office (for appointments etc.) via phone at (301) 357-0038.

NPI number for Mr Travis Deonta Broaddus is 1851015077 and his current mailing address is 7135 Minstrel Way Ste 204-m2, Columbia, Maryland. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1851015077.

Contact Information

	Mr Travis Deonta Broaddus,
	7135 Minstrel Way Ste 204-m2, Columbia, MD 21045-5255
	(301) 357-0038
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Travis Deonta Broaddus
Gender	Male
Speciality	Case Manager/care Coordinator
Location	7135 Minstrel Way Ste 204-m2, Columbia, Maryland
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1851015077
Provider Enumeration Date: 09/30/2022
Last Update Date: 05/08/2023

Medical Identifiers

Medical identifiers for Mr Travis Deonta Broaddus such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1851015077	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary
1041C0700X	Social Worker - Clinical	(* (Not Available))	Secondary
106S00000X	Behavior Technician	(* (Not Available))	Secondary
171M00000X	Case Manager/care Coordinator	(* (Not Available))	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Travis Deonta Broaddus is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Travis Deonta Broaddus, 7135 Minstrel Way Ste 204-m2, Columbia, MD 21045-5255 Ph: (301) 357-0038	Mr Travis Deonta Broaddus, 7135 Minstrel Way Ste 204-m2, Columbia, MD 21045-5255 Ph: (301) 357-0038