Brooklyn Roddenberry, Lcsw, LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Tallahassee, FL. Organization (NPI-2).
NPI number1003621251
StatusActive
Last updated in NPPESAug 13, 2025
Details
- NPI
- 1003621251
- Entity type
- Organization (NPI-2)
- Legal business name
- Brooklyn Roddenberry, Lcsw, LLC
- Organization subpart
- No
- Enumeration date
- Feb 12, 2025
- Certification date
- Aug 13, 2025
- Last updated
- Aug 13, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 1041C0700X | Social Worker, Clinical | – | – |
Practice location
325 John Knox RoadBuilding T, Suite 1
Tallahassee, FL 32303
Phone 850-270-7099
Mailing address
5332 Falling Star DrTallahassee, FL 32303-7823
Authorized official
Brooklyn Love Roddenberry
Owner
8505193928
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