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Organization
ROUNDTABLE COUNSELING CENTER
Active
Organization
ROUNDTABLE COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE TILT (PRACTICE MANAGER)
(765) 490-4808
Entity
Organization
Contact information
Practice address
3741 ROME DR STE B, LAFAYETTE, IN 47905-4490
(765) 490-4808
Mailing address
3741 ROME DR STE B, LAFAYETTE, IN 47905-4490
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
133V00000X
Registered Dietitian
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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