Provider Demographics
NPI:1124145594
Name:ARBOGAST, RENEE (LPC)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:ARBOGAST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 SHILOH TRAIL EAST NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-2024
Mailing Address - Country:US
Mailing Address - Phone:828-333-8595
Mailing Address - Fax:
Practice Address - Street 1:3745 CHEROKEE ST NW STE 101
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6790
Practice Address - Country:US
Practice Address - Phone:828-333-8595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002639101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO493922827Medicaid