MS. EBONI GRACE BROUSSARD (NPI# 1053812982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053812982 |
| Entity Type | Individual |
| Full Name | MS. EBONI GRACE BROUSSARD |
| Credential | MA, NCC |
| Practice Address |
3098 Ashby Dr Macon GA 31204-1502 |
| Practice Telephone | 4044091039 |
| Mailing Telephone | 4044091039 |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2018-02-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Street Address |
3098 ASHBY DR |
| City | MACON |
| State | GA |
| Zip Code | 31204-1502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775085 | Amy Lynn Miller | Counselor | 890 Northwoods Plaza/burrus Road, Macon, GA 31204 | 2018-10-04 |
| 1275056566 | Kenyada Moss | Counselor | 762 Thurmond Dr., Macon, GA 31204 | 2017-07-19 |
| 1508303876 | Amber Foster | Counselor | 890 Northwoods Plaza, Macon, GA 31204 | 2017-01-25 |
| 1952757585 | Sarah Vanselous Spencer | Speech-Language Pathologist | 2720 Sheraton Dr # D-140, Macon, GA 31204 | 2016-05-12 |
| 1952706343 | Matthew Wayne Frazier | Pharmacist | 4260 Log Cabin Dr, Macon, GA 31204 | 2014-10-28 |
| 1215338587 | Sharon Yvette Flewellen | Licensed Practical Nurse | 1876 Moore Street, Macon, GA 31204 | 2014-09-05 |
| 1336565647 | Accel Wellness Center, LLC | Specialist | 3083 Vineville Avenue, Macon, GA 31204 | 2014-03-11 |
| 1821439811 | Irene Gung Ho | Physician Assistant | 3203 Vineville Ave Ste A, Macon, GA 31204 | 2013-07-08 |
| 1518125657 | Jennifer Burns | Marriage & Family Therapist | 116 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| 1255599346 | Methodist Home of The South Georgia Conference, Inc. | Voluntary or Charitable | 304 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| Find all providers in zip 31204 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912528571 | Haylee Ledden | Counselor | 340 Hospital Dr Ste 210, Macon, GA 31217-3838 | 2020-05-05 |
| 1295361277 | Beverly Gail Stewart | Counselor | 9026 Estes Rd, Macon, GA 31220-5673 | 2020-03-21 |
| 1942832993 | Monica Blalock | Counselor | 444 Forest Hill Rd Apt 612, Macon, GA 31210-4834 | 2020-02-07 |
| 1962048496 | Jamie L Thames | Counselor | 4124 Arkwright Rd Ste 2, Macon, GA 31210-1777 | 2019-11-19 |
| 1356808836 | Marnise Harvey | Counselor | 3834 Ridge Ave, Macon, GA 31204-1341 | 2019-02-21 |
| 1013489616 | Jonathan Allen Mendez | Counselor | 2607 Vineville Ave Ste 107, Macon, GA 31204-0900 | 2018-12-19 |
| 1053894352 | Laura Megan Price | Counselor | 3370 Vineville Ave Ste 110, Macon, GA 31204-2331 | 2018-09-12 |
| 1346733417 | Chandra Nicole Albritton | Counselor | 836 Trade Wind Rd, Macon, GA 31206-3785 | 2018-06-12 |
| 1922506625 | Emily Hyde Newberry | Counselor | 3090 Vineville Ave, Macon, GA 31204-2406 | 2018-01-28 |
| 1750804852 | Tamiko Horne | Counselor | 2484 Ingleside Ave Ste 102, Macon, GA 31204-2089 | 2017-07-20 |
| Find all providers in MACON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.