Provider Demographics
NPI:1114508942
Name:ACOFF, RONDELL C (CSAC)
Entity Type:Individual
Prefix:
First Name:RONDELL
Middle Name:C
Last Name:ACOFF
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 DARNABY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-2620
Mailing Address - Country:US
Mailing Address - Phone:504-905-4926
Mailing Address - Fax:757-723-5350
Practice Address - Street 1:403 DARNABY AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23661-2620
Practice Address - Country:US
Practice Address - Phone:504-905-4926
Practice Address - Fax:757-723-5350
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710103446101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)