Healthcare Provider Details

I. General information

NPI: 1538398623
Provider Name (Legal Business Name): DEBORAH C DELLA-RODOLFA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBBIE DELLA-RODOLFA LPC

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6231 HIGHLAND PLACE WAY STE 101
KNOXVILLE TN
37919-4083
US

IV. Provider business mailing address

2607 KINGSTON PIKE STE 250
KNOXVILLE TN
37919-3331
US

V. Phone/Fax

Practice location:
  • Phone: 865-264-2400
  • Fax: 865-588-6406
Mailing address:
  • Phone: 865-264-2400
  • Fax: 865-588-6406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number984
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: