Provider Demographics
NPI:1689088916
Name:ROUNTREE, DRENDA DENISE (MS, NCC, LAPC)
Entity Type:Individual
Prefix:
First Name:DRENDA
Middle Name:DENISE
Last Name:ROUNTREE
Suffix:
Gender:F
Credentials:MS, NCC, LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 OLD 41 HWY NW
Mailing Address - Street 2:SUITE 110
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-4420
Mailing Address - Country:US
Mailing Address - Phone:678-468-9103
Mailing Address - Fax:520-333-2906
Practice Address - Street 1:1815 OLD 41 HWY NW
Practice Address - Street 2:SUITE 110
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-4420
Practice Address - Country:US
Practice Address - Phone:678-468-9103
Practice Address - Fax:520-333-2906
Is Sole Proprietor?:No
Enumeration Date:2014-06-14
Last Update Date:2014-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC003755101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor