Provider Demographics
NPI:1598175085
Name:ROUNDTREE, RODNEY JAMES JR (LCPC)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:JAMES
Last Name:ROUNDTREE
Suffix:JR
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3346
Mailing Address - Country:US
Mailing Address - Phone:410-414-9901
Mailing Address - Fax:
Practice Address - Street 1:590 MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3346
Practice Address - Country:US
Practice Address - Phone:410-414-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5631101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional