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General NPI Number Information
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NPI Number | 1275487605
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Entity Type | Organization
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Legal Business Name | DRYDEN ANCILLARY SERVICES, LLC
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 512 DRYDEN LOOP
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City | DRYDEN
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State | VA
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Zip | 24243
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Country | US
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Telephone | 276-212-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 189 DINSMORE RD
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City | DRYDEN
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State | VA
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Zip | 24243-8378
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Country | US
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Telephone | 941-391-7261
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Fax |
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Authorized Official
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Title or Position | RCM
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Name | TRACY ROGERS
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Credential | LMHC, LPC
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Telephone | 941-391-7261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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