Provider Demographics
NPI:1679931612
Name:POMERLYAN, APRIL BROADWATER (MAED, LCMHC)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:BROADWATER
Last Name:POMERLYAN
Suffix:
Gender:F
Credentials:MAED, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6824 WILSON GROVE RD
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-4239
Mailing Address - Country:US
Mailing Address - Phone:704-849-0144
Mailing Address - Fax:704-845-1611
Practice Address - Street 1:6824 WILSON GROVE RD
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-4239
Practice Address - Country:US
Practice Address - Phone:980-290-4752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11996101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCLPC11996OtherNCBLPC