Healthcare Provider Details

I. General information

NPI: 1912741372
Provider Name (Legal Business Name): RONDA T GANDY MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RONDA GANDY MS, LPC

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 W EVANS ST STE 2
FLORENCE SC
29501-3317
US

IV. Provider business mailing address

PO BOX 846 1816 N. GOVERNOR WILLIAMS HWY
DARLINGTON SC
29540-0846
US

V. Phone/Fax

Practice location:
  • Phone: 864-538-6906
  • Fax: 864-479-4141
Mailing address:
  • Phone: 843-861-0006
  • Fax: 864-479-4141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11393
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: