Provider Demographics
NPI:1982034484
Name:BROMM, MINDY C (NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:MINDY
Middle Name:C
Last Name:BROMM
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 FAIRVIEW POINTE DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3223
Mailing Address - Country:US
Mailing Address - Phone:864-757-8966
Mailing Address - Fax:864-757-8965
Practice Address - Street 1:113 FAIRVIEW POINTE DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3223
Practice Address - Country:US
Practice Address - Phone:864-757-8966
Practice Address - Fax:864-757-8965
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health