DENNIS L HERENDEEN (NPI# 1629039813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629039813 |
| Entity Type | Individual |
| Full Name | DENNIS L HERENDEEN |
| Credential | PH.D. |
| Practice Address |
6130 Prestley Mill Rd Suite A Douglasville GA 30134-2288 |
| Practice Telephone | 7709499675 |
| Practice Fax Number | 7709499676 |
| Mailing Telephone | 7709499675 |
| Mailing Fax Number | 7709499676 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TF0200X |
Psychologist Specialization: Forensic |
PSY000444 | GA | Behavioral Health & Social Service Providers |
| Street Address |
6130 PRESTLEY MILL RD SUITE A |
| City | DOUGLASVILLE |
| State | GA |
| Zip Code | 30134-2288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831150028 | Samuel Delafield Haskell | Psychologist | 6130 Prestley Mill Rd, Suite A, Douglasville, GA 30134-2288 | 2006-03-29 |
| 1841431277 | Kristy Strickland Moore | Nurse Practitioner | 6130 Prestley Mill Rd, Suite B, Douglasville, GA 30134-2288 | 2009-03-15 |
| 1528029089 | Stacy Jaynes Anderson | Counselor | 6130 Prestley Mill Rd, Suite A, Douglasville, GA 30134-2288 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851915631 | Lilian Pereira | Nurse Practitioner | Bethesda Medical Group, LLC, 9280 Hwy 5 - Suite D, Douglasville, GA 30134 | 2020-06-08 |
| 1548822901 | Sweet Resolve LLC | Nurse Practitioner | 4318 Ridge Rd, Ste 111 Pmb 1017, Douglasville, GA 30134 | 2019-07-05 |
| 1598328791 | Straight Street Life Center Inc | Case Manager/Care Coordinator | 12461 Veterans Memorial, Douglasville, GA 30134 | 2019-04-15 |
| 1174014930 | Caitlin Waldrip | Chiropractor | 8326a Office Park Dr., Douglasville, GA 30134 | 2018-05-28 |
| 1861901050 | Michelle Denise Winston | Licensed Practical Nurse | 6497 E Strickland, Douglasville, GA 30134 | 2017-09-20 |
| 1518335843 | Willis Anthony Rogers | Durable Medical Equipment & Medical Supplies | 7094 Rose Lake Circle, Douglasville, GA 30134 | 2015-09-03 |
| 1497135131 | Patricia Warren | Social Worker | 8317 Office Park Drive Ste.#e, Douglasville, GA 30134 | 2015-06-08 |
| 1457747321 | Kidz Rock Therapy Services, LLC | Occupational Therapist | 6732 West Spring Street, Douglasville, GA 30134 | 2015-04-08 |
| 1386068476 | Naa Y Oden | Psychologist | 4813 Ridge Rd Ste 111-639, Douglasville, GA 30134 | 2014-02-10 |
| 1467893271 | American Ems | Ambulance | 7240 Bankhead Hwy, Douglasville, GA 30134 | 2013-07-09 |
| Find all providers in zip 30134 | ||||
| Taxonomy Code | 103TF0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Forensic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932720489 | Avs Consulting | Psychologist | 4015 S Cobb Dr Se Ste 265, Smyrna, GA 30080-6374 | 2020-05-06 |
| 1356492037 | James Edwin Stark | Psychologist | 1755 The Exchange Se, Suite 375, Atlanta, GA 30339-7400 | 2007-01-16 |
| 1639564271 | Colbi Sutton | Psychologist | 49 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3049 | 2015-03-31 |
| 1487059580 | Neurobehavioral Associates LLC | Psychologist | 639 13th St, Augusta, GA 30901-1007 | 2014-10-31 |
| 1063766467 | Rommys Alemania Beltran | Psychologist | 2662 Holcomb Bridge Rd, Suite 340, Alpharetta, GA 30022-6819 | 2012-11-07 |
| 1245476639 | Marc David Einhorn | Psychologist | 11755 Pointe Pl, Roswell, GA 30076-4656 | 2009-01-06 |
| 1922266014 | Southern Psychological Services | Psychologist | 1213 E Jackson St, Thomasville, GA 31792-4748 | 2008-05-27 |
| 1609943240 | Kelly Leanne Farris | Psychologist | 3000 Schatulga Rd, Bldg. 5, Columbus, GA 31907-3117 | 2006-11-29 |
| City | DOUGLASVILLE |
| Zip Code | 30134 |
Please comment or provide details below to improve the information on DENNIS L HERENDEEN.
| 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.