Provider Demographics
NPI:1558818120
Name:BRODSKY, ANNA SPRAGUE (LCMHC,LCAS)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:SPRAGUE
Last Name:BRODSKY
Suffix:
Gender:F
Credentials:LCMHC,LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2272
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-2272
Mailing Address - Country:US
Mailing Address - Phone:828-692-7300
Mailing Address - Fax:828-692-7710
Practice Address - Street 1:110 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-4543
Practice Address - Country:US
Practice Address - Phone:828-692-7300
Practice Address - Fax:828-692-7710
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23231101YA0400X
NC12156101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12156OtherLCMHC
NC1558818120Medicaid
NC23231OtherLCAS