Provider Demographics
NPI:1548967433
Name:DENNIS, ROLANDA (RCSWI, MSW)
Entity type:Individual
Prefix:
First Name:ROLANDA
Middle Name:
Last Name:DENNIS
Suffix:
Gender:F
Credentials:RCSWI, MSW
Other - Prefix:
Other - First Name:ROLANDA
Other - Middle Name:
Other - Last Name:BROWN-DENNIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RCSWI, MSW
Mailing Address - Street 1:3551 S BLAIR STONE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-8829
Mailing Address - Country:US
Mailing Address - Phone:850-766-8873
Mailing Address - Fax:
Practice Address - Street 1:2700 S BLAIR STONE RD STE 206
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-5928
Practice Address - Country:US
Practice Address - Phone:850-544-2184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FLISW162421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical