Provider Demographics
NPI:1578800165
Name:ILENDA, AMERICA ANDERSON (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMERICA
Middle Name:ANDERSON
Last Name:ILENDA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 WEXFORD HOLLOW RUN
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1490
Mailing Address - Country:US
Mailing Address - Phone:404-556-6662
Mailing Address - Fax:
Practice Address - Street 1:1745 WOODSTOCK RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2367
Practice Address - Country:US
Practice Address - Phone:404-556-6662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004113101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional