Healthcare Provider Details

I. General information

NPI: 1811802176
Provider Name (Legal Business Name): ANDREW GRENEKER M.S., APC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 COLONY PARK DR STE 300
CUMMING GA
30040-2773
US

IV. Provider business mailing address

2865 TORREYA WAY SE
MARIETTA GA
30067-6031
US

V. Phone/Fax

Practice location:
  • Phone: 470-757-1128
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC011335
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: