Provider Demographics
NPI:1518231471
Name:BRYANT, RHONDA M (LPC)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:M
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:662 DAVE BRUBECK WAY
Mailing Address - Street 2:# 4
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-1835
Mailing Address - Country:US
Mailing Address - Phone:229-234-2872
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 360
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24068-0360
Practice Address - Country:US
Practice Address - Phone:209-403-0370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC69988101YP2500X
GALPC004462101YP2500X
VA0701011482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional