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RICKY LEE BROUGHTON PRSS
NPI 1639806227
Peer Specialist in Logan, WV

Active since August 03, 2022
1112 ENTERPRISE DRIVE, LOGAN, WV 25601(304) 896-6871 Get Directions Write a Review

NPPES record last updated: August 3, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ricky Lee Broughton Prss NPPES

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

RICKY LEE BROUGHTON PRSS (NPI 1639806227) is an individual peer specialist in Logan, West Virginia, licensed in West Virginia (21-818) and active in the NPI registry since August 2022.

NPPES Registry Identity

NPI1639806227
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameRICKY LEE BROUGHTONCredential: PRSS
Location Address1112 ENTERPRISE DRIVELogan, WV 25601
Mailing Address1112 Enterprise DriveLogan, WV 25601 · (304) 896-6871
Phone(304) 896-6871
Sole ProprietorNo
Enumeration DateAugust 3, 2022
NPPES CertifiedJuly 26, 2022
✔ NPI 1639806227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in WV · 21-818
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
1112 ENTERPRISE DRIVE, Logan, WV 25601
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Other Providers at the Same Location NPPES 2

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

CHRISTOPHER L BAKER
Peer Specialist
1112 ENTERPRISE DRIVE
LOGAN, WV 25601
Logan County (304) 896-6871
JOSEPH MCCOMAS PRSS
Peer Specialist
1112 ENTERPRISE DRIVE
LOGAN, WV 25601
Logan County (304) 896-6871

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 Ricky Broughton's NPI number?

The NPI number for Ricky Broughton is 1639806227. It was assigned to this individual provider in the NPPES registry on August 3, 2022.

Where is Ricky Broughton located?

Ricky Broughton practices at 1112 Enterprise Drive, Logan, WV 25601. The listed phone number is (304) 896-6871.

What is Ricky Broughton's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Ricky Broughton was last updated on August 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.