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ROOSEVELT BROACH
NPI 1083280374
Counselor - Mental Health in Dallas, TX

Active since May 27, 2021
12959 JUPITER RD STE 140, DALLAS, TX 75238(214) 221-0132 Get Directions Write a Review

NPPES record last updated: May 27, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Roosevelt Broach NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROOSEVELT BROACH (NPI 1083280374) is an individual mental health provider in Dallas, Texas, licensed in Texas (79180) and active in the NPI registry since May 2021.

NPPES Registry Identity

NPI1083280374
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameROOSEVELT BROACH
Location Address12959 JUPITER RD STE 140Dallas, TX 75238-3200
Mailing Address502 Point Royal DrRockwall, TX 75087-8721 · (469) 688-2803
Phone(214) 221-0132
Sole ProprietorYes
Enumeration DateMay 27, 2021
NPPES CertifiedMay 27, 2021
✔ NPI 1083280374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in TX · 79180
12959 JUPITER RD STE 140, Dallas, TX 75238
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Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

2020 COUNSELING LLC
Counselor (Professional)
12959 JUPITER RD STE 140
DALLAS, TX 75238
Dallas County (817) 903-0200
ALICIA BRIGHAM LPC
Counselor (Mental Health)
12959 JUPITER RD STE 140
DALLAS, TX 75238
Dallas County (817) 879-2215
ZOOM HOUSE CALL PROVIDERS
Nurse Practitioner (Family)
12959 JUPITER RD STE 140
DALLAS, TX 75238
Dallas County (817) 405-9410
LAURA KAY MCDONALD
Counselor (Professional)
12959 JUPITER RD STE 140
DALLAS, TX 75238
Dallas County (214) 221-0132
ACCESS HEALTHCARE PROVIDERS LLC
Nurse Practitioner (Psychiatric/Mental Health)
12959 JUPITER RD STE 140
DALLAS, TX 75238
Dallas County (360) 322-4665
ZOOM HEALTH SERVICES INCORPORATION
Clinic/Center (Adult Mental Health)
12959 JUPITER RD STE 140
DALLAS, TX 75238
Dallas County (214) 221-0132
ROSLYN DENISE BROACH
Counselor (Professional)
12959 JUPITER RD STE 140
DALLAS, TX 75238
Dallas County (214) 221-0132

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roosevelt Broach's NPI number?

The NPI number for Roosevelt Broach is 1083280374. It was assigned to this individual provider in the NPPES registry on May 27, 2021.

Where is Roosevelt Broach located?

Roosevelt Broach practices at 12959 Jupiter Rd Ste 140, Dallas, TX 75238. The listed phone number is (214) 221-0132.

What is Roosevelt Broach's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Roosevelt Broach was last updated on May 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.