Provider Demographics
NPI:1164863130
Name:HUNTER, ROANE T JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:ROANE
Middle Name:T
Last Name:HUNTER
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:ROE
Other - Middle Name:
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:5350 JAMAICA DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-4057
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5350 JAMAICA DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-4057
Practice Address - Country:US
Practice Address - Phone:601-850-6636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health