| Malcolm L Broadnax, | |
|
4412 Cole Farm Rd, Nottingham, MD 21236-2961 | |
| (443) 528-0822 | |
| Not Available |
| Full Name | Malcolm L Broadnax |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 4 Years |
| Location | 4412 Cole Farm Rd, Nottingham, Maryland |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457193278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LGP14898 (Maryland) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LCA3486 (Maryland) | Primary |
| Entity Name | Awake & Rooted Wellness & Recovery LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407740582 PECOS PAC ID: 7214439702 Enrollment ID: O20250904002561 |
| Mailing Address | Practice Location Address |
|---|---|
| Malcolm L Broadnax, 2710 Pelham Ave, Baltimore, MD 21213-1119 Ph: (443) 528-0822 | Malcolm L Broadnax, 4412 Cole Farm Rd, Nottingham, MD 21236-2961 Ph: (443) 528-0822 |
Cynthia M Holden, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 15 Arlen Rd Apt I, Nottingham, MD 21236 Phone: 301-531-5066 |
Trac Nguyen, Counselor Medicare: Accepting Medicare Assignments Practice Location: 5026 Campbell Blvd Ste H, Nottingham, MD 21236 Phone: 410-780-2692 |
Christopher Faria, LCPC Counselor Medicare: Accepting Medicare Assignments Practice Location: 9649 Belair Rd Ste 104, Nottingham, MD 21236 Phone: 410-529-1309 |
John Kemp Holland, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7939 Honeygo Blvd Ste 224, Nottingham, MD 21236 Phone: 410-933-3700 |
Nicole Marie Zell, LGPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5022 Campbell Blvd Ste L-m, Nottingham, MD 21236 Phone: 443-442-1568 |
Ms. Habiba Bickersteth Adebiyi, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 7939 Honeygo Blvd Ste 224, Nottingham, MD 21236 Phone: 443-750-2464 |
Jennifer Mallery Marski, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7939 Honeygo Blvd Ste 224, Nottingham, MD 21236 Phone: 410-933-3700 Fax: 410-933-9200 |