Shadisha K Bennett Brodde, LPC - Counselor in Saint Augustine, FL

Shadisha K Bennett Brodde, LPC is a Counselor - Mental Health based in Saint Augustine, Florida. Shadisha K Bennett Brodde is licensed to practice in Florida (license number MH18303) and her current practice location is 910 Golden Lake Loop, Saint Augustine, Florida. She can be reached at her office (for appointments etc.) via phone at (478) 387-5582.

NPI number for Shadisha K Bennett Brodde is 1477826022 and her current mailing address is 910 Golden Lake Loop, Saint Augustine, Florida. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1477826022.

Contact Information

Shadisha K Bennett Brodde, LPC
910 Golden Lake Loop,
Saint Augustine, FL 32084-5877
(478) 387-5582
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameShadisha K Bennett Brodde
GenderFemale
SpecialityCounselor - Mental Health
Location910 Golden Lake Loop, Saint Augustine, Florida
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1477826022
  • Provider Enumeration Date: 02/13/2012
  • Last Update Date: 06/16/2021

Medical Identifiers

Medical identifiers for Shadisha K Bennett Brodde such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1477826022NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YP2500XCounselor - Professional 178005880 (Illinois)Secondary
101YM0800XCounselor - Mental Health MH18303 (Florida)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. Shadisha K Bennett Brodde 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 AddressPractice Location Address
Shadisha K Bennett Brodde, LPC
910 Golden Lake Loop,
Saint Augustine, FL 32084-5877

Ph: (478) 387-5582
Shadisha K Bennett Brodde, LPC
910 Golden Lake Loop,
Saint Augustine, FL 32084-5877

Ph: (478) 387-5582

Reviews and Comments


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