Provider Demographics
NPI:1629410907
Name:WODZENSKI, DARLEEN CLAIRE (LPC)
Entity Type:Individual
Prefix:DR
First Name:DARLEEN
Middle Name:CLAIRE
Last Name:WODZENSKI
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 1:231 BENTONVILLE LN
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-6301
Mailing Address - Country:US
Mailing Address - Phone:770-686-0894
Mailing Address - Fax:877-350-3067
Practice Address - Street 1:2725 CHARLESTOWN DR
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337-3909
Practice Address - Country:US
Practice Address - Phone:770-686-0894
Practice Address - Fax:877-660-8884
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
GAMT002427173C00000X
GALPC011101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No173C00000XOther Service ProvidersReflexologist