Jerriod Nicholas Broadnax, LADAC, NCAC-II, CFC - Counselor in Fayetteville, AR

Jerriod Nicholas Broadnax, LADAC, NCAC-II, CFC is a Counselor - Addiction (substance Use Disorder) based in Fayetteville, Arkansas. Jerriod Nicholas Broadnax is licensed to practice in Arkansas (license number 333L) and his current practice location is 509 E. Milsap Road, Suite 9, Fayetteville, Arkansas. He can be reached at his office (for appointments etc.) via phone at (479) 879-7038.

NPI number for Jerriod Nicholas Broadnax is 1427116581 and his current mailing address is 2926 N. Susan Carol Lane, Fayetteville, Arkansas. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1427116581.

Contact Information

Jerriod Nicholas Broadnax, LADAC, NCAC-II, CFC
509 E. Milsap Road, Suite 9,
Fayetteville, AR 72703
(479) 879-7038
(479) 340-0500

Map and Direction


Healthcare Provider's Profile

Full NameJerriod Nicholas Broadnax
GenderMale
SpecialityCounselor - Addiction (substance Use Disorder)
Location509 E. Milsap Road, Fayetteville, Arkansas
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1427116581
  • Provider Enumeration Date: 12/04/2006
  • Last Update Date: 08/10/2021

Medical Identifiers

Medical identifiers for Jerriod Nicholas Broadnax such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1427116581NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101Y00000XCounselor 28533 (Indiana)Secondary
101YP2500XCounselor - Professional 016701 (Virginia)Secondary
171M00000XCase Manager/care Coordinator (* (Not Available))Secondary
101YA0400XCounselor - Addiction (substance Use Disorder) 333L (Arkansas)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. Jerriod Nicholas Broadnax 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
Jerriod Nicholas Broadnax, LADAC, NCAC-II, CFC
2926 N. Susan Carol Lane,
Fayetteville, AR 72703

Ph: (479) 445-8142
Jerriod Nicholas Broadnax, LADAC, NCAC-II, CFC
509 E. Milsap Road, Suite 9,
Fayetteville, AR 72703

Ph: (479) 879-7038

Reviews and Comments


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Talor M Tartaglia,
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Medicare: Not Enrolled in Medicare
Practice Location: 60 W Sunbridge Dr, Fayetteville, AR 72703
Phone: 479-695-1240    Fax: 479-750-4843

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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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