Healthcare Provider Details

I. General information

NPI: 1265986137
Provider Name (Legal Business Name): SHRETTA RHONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHRETTA RHONE LPC

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 08/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 PHARR COURT NORTH NW STE 27
ATLANTA GA
30305-2054
US

IV. Provider business mailing address

PO BOX 161724
ATLANTA GA
30321-1724
US

V. Phone/Fax

Practice location:
  • Phone: 404-848-9303
  • Fax:
Mailing address:
  • Phone: 404-848-9303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC008831
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC008831
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: