| Latasha Broomfield, MA, LPC, NCC, CACI | |
| 409 Simpkins St, Edgefield, SC 29824-1313 | |
| (803) 637-5788 | |
| Not Available | 
| Full Name | Latasha Broomfield | 
|---|---|
| Gender | Female | 
| Speciality | Counselor - Professional | 
| Location | 409 Simpkins St, Edgefield, South Carolina | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1699192096 | NPI | - | NPPES | 
| 421504 | Medicaid | SC | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 6126 (South Carolina) | Primary | 
| Entity Name | South Carolina Dept Of Mental Health Accounting Office | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1295332690 PECOS PAC ID: 9032021175 Enrollment ID: O20031107000041 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Latasha Broomfield, MA, LPC, NCC, CACI 409 Simpkins St, Edgefield, SC 29824-1313 Ph: (803) 637-5788 | Latasha Broomfield, MA, LPC, NCC, CACI 409 Simpkins St, Edgefield, SC 29824-1313 Ph: (803) 637-5788 | 
| Mrs. Gail Smith, M. ED., LPC Counselor Medicare: Medicare Enrolled Practice Location: 200 Ridge Medical Plaza Rd, Edgefield, SC 29824 Phone: 803-637-5788 Fax: 803-637-0753 | |
| Ms. Carole Ann Chidley, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 409 Simpkins St, Edgefield, SC 29824 Phone: 803-637-5788 Fax: 803-637-0753 | |
| Ms. Myrdis Y. Sheppard, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 409 Simpkins St, Edgefield, SC 29824 Phone: 803-637-5338 Fax: 803-637-0753 | |
| Ms. Winifred Jean Eubanks, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 409 Simpkins St, Edgefield, SC 29824 Phone: 803-637-5788 | |
| Mrs. Cheryl H Lindler, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 409 Simpkins St, Edgefield, SC 29824 Phone: 803-637-5788 Fax: 803-637-0753 | |
| Ms. Sherry Leigh Paschal, CPSS Counselor Medicare: Not Enrolled in Medicare Practice Location: 409 Simpkins St, Edgefield, SC 29824 Phone: 803-637-7588 |