Provider Demographics
NPI:1205201613
Name:ROOP, JOSHUA (LMHC, NCC, CAP)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:ROOP
Suffix:
Gender:M
Credentials:LMHC, NCC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 PARK DR STE 2F
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1023
Mailing Address - Country:US
Mailing Address - Phone:614-382-0965
Mailing Address - Fax:
Practice Address - Street 1:2725 PARK DR STE 2F
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763
Practice Address - Country:US
Practice Address - Phone:614-382-0965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13451101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health