| Brooklyn Roddenberry, Lcsw, Llc | |
|
325 John Knox Road Building T, Suite 1 Tallahassee FL 32303 | |
| (850) 270-7099 | |
| Not Available |
| Full Name | Brooklyn Roddenberry, Lcsw, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 325 John Knox Road, Tallahassee, Florida |
| Authorized Official Name and Position | Brooklyn Love Roddenberry (OWNER) |
| Authorized Official Contact | 8505193928 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brooklyn Roddenberry, Lcsw, Llc 5332 Falling Star Dr Tallahassee FL 32303-7823 Ph: () - | Brooklyn Roddenberry, Lcsw, Llc 325 John Knox Road Building T, Suite 1 Tallahassee FL 32303 Ph: (850) 270-7099 |
| NPI Number | 1003621251 |
|---|---|
| Provider Enumeration Date | 02/12/2025 |
| Last Update Date | 02/12/2025 |
| Certification Date | 02/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003621251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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