Healthcare Provider Details

I. General information

NPI: 1619882966
Provider Name (Legal Business Name): RODNEY LEE LMSW
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

7939 HONEYGO BLVD STE 224
NOTTINGHAM MD
21236-5992
US

IV. Provider business mailing address

7939 HONEYGO BLVD STE 224
NOTTINGHAM MD
21236-5992
US

V. Phone/Fax

Practice location:
  • Phone: 410-933-3700
  • Fax:
Mailing address:
  • Phone: 410-933-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberG11534
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: