ROSELANDE DOMOND (NPI# 1366847444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366847444 |
Entity Type | Individual |
Full Name | ROSELANDE DOMOND |
Credential | LPC |
Practice Address |
135 Bradford Sq Ste B Fayetteville GA 30215-1902 |
Mailing Address |
11658 Kades Trl Hampton GA 30228-4012 |
Practice Telephone | 6788869112 |
Practice Fax Number | 4049009088 |
Mailing Telephone | 6788869112 |
Enumeration Date | 2014-10-30 |
Last Update Date | 2020-06-29 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YP2500X |
Counselor Specialization: Professional |
LPC007883 | GA | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 003169295A | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
11658 Kades Trl, Hampton, GA 302284012 | 6788869112 | |
135 Eagles Walk Ste 150, Stockbridge, GA 302817238 | 6788869112 | 4049009088 |
Street Address |
135 BRADFORD SQ STE B |
City | FAYETTEVILLE |
State | GA |
Zip Code | 30215-1902 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497387963 | Diamond Counseling and Coaching, LLC | Counselor | 135 Bradford Sq Ste B, Fayetteville, GA 30215-1902 | 2020-02-12 |
1548729080 | Tyrone Smith | Nurse Practitioner | 135 Bradford Sq Ste B, Fayetteville, GA 30215-1902 | 2019-03-14 |
1285119925 | Mindset Healthcare, PC | Nurse Practitioner | 135 Bradford Sq Ste B, Fayetteville, GA 30215-1902 | 2018-09-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801370051 | Truly Nourished, LLC | Dietitian, Registered | 500 West Lanier Ave., Suite 908, Fayetteville, GA 30215 | 2018-09-23 |
1104343839 | Pandora G Brown | Specialist | 65 Black Watch Ct, Fayetteville, GA 30215 | 2017-08-23 |
1902264492 | Ty-re Lamont Dixon Sr. | Durable Medical Equipment & Medical Supplies | 220 Shoreline Dr., Fayetteville, GA 30215 | 2016-01-29 |
1962870030 | Matthew Christian Alvarez | Dentist | 113 Ebenezer Rd Ste 101, Fayetteville, GA 30215 | 2015-09-08 |
1831534346 | Kevin Tyler Goelz | Radiology | 605 Wentworth Ct, Fayetteville, GA 30215 | 2013-05-10 |
1518249739 | William J. Holcomb | Pharmacist | 880 Hwy 85 South, Fayetteville, GA 30215 | 2011-09-14 |
1407168131 | All Care Home Health Equipment, LLC | Durable Medical Equipment & Medical Supplies | 1000 Cooper Circle, Suite 201, Fayetteville, GA 30215 | 2010-07-10 |
1083854160 | Rachel Blanks | Licensed Practical Nurse | 170 Brookwood Lane, Fayetteville, GA 30215 | 2009-03-02 |
1093964975 | Brenda Carole Hayek | Nurse Practitioner | 735 Glynn Street S, Fayetteville, GA 30215 | 2008-09-16 |
1174700769 | Katheryn D. Mcdonell | Counselor | 110 Dawn Drive, Fayetteville, GA 30215 | 2008-01-25 |
Find all providers in zip 30215 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841899986 | Cynthia Hrdlichka | Counselor | 2224 E Elaine Ave, Fayetteville, AR 72703-4507 | 2020-10-20 |
1568069169 | Blaire Bradbury | Counselor | 1466 N Desoto Pl, Fayetteville, AR 72703-1953 | 2020-10-06 |
1588294631 | Puzzle Collaborative | Counselor | 34 W Colt Square Dr Ste 1, Fayetteville, AR 72703-2888 | 2020-01-16 |
1700421724 | Waylon Vande Hoef | Counselor | 1925 N Green Acres Rd, Fayetteville, AR 72703-2617 | 2019-11-13 |
1730640137 | Sherrita Hedgepeth | Counselor | 1351 Glen Iris Dr Apt 105, Fayetteville, NC 28314-6190 | 2019-03-28 |
1689139362 | Resiliency Behavioral Health Services LLC | Counselor | 145 Govenors Square, Ste A, Fayetteville, GA 30269 | 2019-02-06 |
1073006540 | Rona Gooden | Counselor | 706 Dandridge Dr, Fayetteville, NC 28303-2017 | 2018-06-10 |
1194229245 | The Welling Place LLC | Counselor | 2525 Raeford Rd Ste C, Fayetteville, NC 28305-5092 | 2018-03-22 |
1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
1376062539 | Monique R Darnell | Counselor | 320 W. Lanier Avenue Ste 200, Fayetteville, GA 30214 | 2017-09-19 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 30215 |
Please comment or provide details below to improve the information on ROSELANDE DOMOND.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.