Organization Active NPI

Rogue Sun Counseling & Consulting, LLC

  • Clinical Social Worker
  • Dallas, GA
National Provider Identifier
1962294553
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ROGUE SUN COUNSELING & CONSULTING, LLC
Practice address
377 Blackgum Trce
Dallas, GA 30132-5563
Phone
(770) 757-2716
NPI assigned
May 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Jeff Duckworth, LCSW
Title
Owner
Phone
(770) 757-2716

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

377 Blackgum Trce
Dallas, GA 30132-5563

Mailing address

377 Blackgum Trce
Dallas, GA 30132-5563

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1962294553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 BLACKGUM TRCE",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301325563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 BLACKGUM TRCE",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301325563",
            "telephone_number": "770-757-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE SUN COUNSELING & CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "DUCKWORTH",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-757-2716",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.