KEENAN BRODERICK - NPI 1962760785 - Counselor in Buffalo, NY

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

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About Keenan Broderick NPPES

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

KEENAN BRODERICK (NPI 1962760785) is an individual counselor in Buffalo, New York and active in the NPI registry since April 2012.

NPPES Registry Identity

NPI1962760785

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameKEENAN BRODERICK

Location Address3020 BAILEY AVE, 2ND FLOORBuffalo, NY 14215-2814

Mailing Address3020 Bailey Ave, 2nd FloorBuffalo, NY 14215-2814 · (716) 831-1800 · Fax (716) 831-1818

Phone(716) 831-1800

Fax(716) 831-1818

Sole ProprietorNo

Enumeration DateApril 30, 2012

✔ NPI 1962760785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

3020 BAILEY AVE, Buffalo, NY 14215

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