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KEENAN BRODERICK
NPI 1962760785
Counselor in Buffalo, NY

Active since April 30, 2012
3020 BAILEY AVE, 2ND FLOOR, BUFFALO, NY 14215(716) 831-1800(716) 831-1818 Get Directions Write a Review

NPPES record last updated: April 30, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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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Other Providers at the Same Location NPPES 20

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

REBEKAH MOSHER
Counselor (Addiction (Substance Use Disorder))
3020 BAILEY AVE, 2ND FLOOR
BUFFALO, NY 14215
Erie County (716) 831-1800
BONNIE PARKOT
Counselor
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 831-2700
BLAIR BUCZKOWSKI
Registered Nurse
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 831-2700
VANESSA CHINEMELUM ABUDEI
Counselor
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 833-3622
MRS. SARAH KATHRYN HALL MS
Counselor (Addiction (Substance Use Disorder))
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 831-1850
MS. KELLY ANN SPEARS CASAC-T
Counselor (Mental Health)
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 830-1800
RONALD G KRASKA O.T.R.
Counselor (Mental Health)
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 831-1800
HEATHER MENDYK
Counselor (Addiction (Substance Use Disorder))
3020 BAILEY AVE, 2ND FLOOR
BUFFALO, NY 14215
Erie County (716) 831-1800

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 Keenan Broderick's NPI number?

The NPI number for Keenan Broderick is 1962760785. It was assigned to this individual provider in the NPPES registry on April 30, 2012.

Where is Keenan Broderick located?

Keenan Broderick practices at 3020 Bailey Ave 2nd Floor, Buffalo, NY 14215. The listed phone number is (716) 831-1800.

What is Keenan Broderick's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Keenan Broderick was last updated on April 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.