DENNIS L HERENDEEN (PH.D.) – Forensic Psychologist, NPI 1629039813

DENNIS L HERENDEEN (PH.D.) is a healthcare provider. based in Douglasville, Georgia. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PSY000444 (GA). The NPI Number for DENNIS L HERENDEEN (PH.D.) is 1629039813

Main info

Male
54 Years Of Experience
Accepts Medicare Assignment
Name
DENNIS L HERENDEEN (PH.D.)
NPI
1629039813
Phone
(770) 949-9675
Address
6130 PRESTLEY MILL RD
Enumeration Date
29 March 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1972 (54 years ago)
PAC ID
6800068818
Professional Enrollment ID
I20111018000384
Address ID
GA301342288DO6130XAXXX500
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

486 CLINICAL PSYCHOLOGIST in GA

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Provider Addresses for DENNIS L HERENDEEN (PH.D.)

  • 6130, Prestley Mill Road, Anneewakee Heights, Douglasville, Douglas County, Georgia, 30134, United States

    SUITE A

    DOUGLASVILLE, GA 301342288

    Phone: (770) 949-9675

    Fax: (770) 949-9676

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-10-18

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111018000384IPsychologist Billing IndependentlyGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes36220$0
90832Psychotherapy, 30 minutes1911$0
View full utilization report →

Insurance plans in this area (ZIP 30134)

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Reviews

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Frequently asked questions

Does DENNIS L HERENDEEN (PH.D.) have a public NPI I can cite?
Public records show DENNIS L HERENDEEN (PH.D.) under NPI 1629039813.
Is DENNIS L HERENDEEN (PH.D.) currently accepting referrals based on NPI status?
Registry metadata lists DENNIS L HERENDEEN (PH.D.) as active.
What type of care does DENNIS L HERENDEEN (PH.D.) provide?
DENNIS L HERENDEEN (PH.D.)'s profile centers on Forensic Psychologist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DENNIS L HERENDEEN (PH.D.)?
DENNIS L HERENDEEN (PH.D.) is associated with Douglasville, Georgia in the same public data insurers reference.
Who maintains DENNIS L HERENDEEN (PH.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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