Healthcare Provider Details

I. General information

NPI: 1184794513
Provider Name (Legal Business Name): ROBERT P RONEY D MIN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 SOUTH BERKELEY LAKE RD SUITE B
NORCROSS GA
30071
US

IV. Provider business mailing address

4530 SOUTH BERKELEY LAKE RD SUITE B
NORCROSS GA
30071
US

V. Phone/Fax

Practice location:
  • Phone: 770-446-5642
  • Fax: 770-446-5643
Mailing address:
  • Phone: 770-446-5642
  • Fax: 770-446-5643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1407
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: ROBERT P RONEY
Title or Position: CEO
Credential: D MIN
Phone: 770-446-5642