Individual provider Active NPI

Renee Arbogast, L.P.C.

  • Professional Counselor
  • Kennesaw, GA
National Provider Identifier
1124145594
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
002639 Issued in MO
Practice address
3745 Cherokee St NW Ste 101
Kennesaw, GA 30144-6790
Phone
(828) 333-8595
NPI assigned
Mar 23, 2007
Last updated
Feb 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 002639 MO Primary

Addresses

Primary practice location

3745 Cherokee St NW Ste 101
Kennesaw, GA 30144-6790

Mailing address

1361 Shiloh Trail East NW
Kennesaw, GA 30144-2024
Phone (828) 333-8595

Other identifiers 1

IdentifierTypeStateIssuer
493922827MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
002639MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kennesaw Trauma and Addiction Center CurrentSince Feb 9, 2025 Accepting new patients

Locations

3745 Cherokee St NW
Ste 101
Kennesaw, GA 30144
Phone (678) 927-6471

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1124145594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 SHILOH TRAIL EAST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442024",
            "telephone_number": "828-333-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 CHEROKEE ST NW STE 101",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446790",
            "telephone_number": "828-333-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARBOGAST",
        "first_name": "RENEE",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "002639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493922827",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.