DAVID EDWIN RODDENBERRY NPI 1962217489

NPI Information

  • NPI: 1962217489
  • Provider Name: DAVID EDWIN RODDENBERRY
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 109 NATURE WALK PKWY UNIT 104
    SAINT AUGUSTINE, FL
    ZIP 32092
  • Phone: (407) 748-0982

Map and Directions

Get Directions

NPI Details

David Edwin Roddenberry is a mental health counselor in Saint Augustine, FL. David Edwin Roddenberry NPI is 1962217489. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

109 NATURE WALK PKWY UNIT 104
SAINT AUGUSTINE, FL
ZIP 32092-065
Phone: (407) 748-0982

The enumeration date for this NPI number is 2/11/2025 and was last updated on 3/4/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthMH25268FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.