Provider Demographics
NPI:1043918618
Name:ROACH, JULIA ELIZABETH (MHSP-LPC (TEMP))
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ELIZABETH
Last Name:ROACH
Suffix:
Gender:F
Credentials:MHSP-LPC (TEMP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 CROMFORD PL
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-8449
Mailing Address - Country:US
Mailing Address - Phone:615-812-0027
Mailing Address - Fax:
Practice Address - Street 1:9025 OVERLOOK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027
Practice Address - Country:US
Practice Address - Phone:615-861-9918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty