Provider Demographics
NPI:1316414493
Name:ROBERTS, JULES DANE (LPC)
Entity Type:Individual
Prefix:
First Name:JULES
Middle Name:DANE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ROBERTS
Other - Last Name:WOODSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1789 S BRADDOCK AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1881
Mailing Address - Country:US
Mailing Address - Phone:412-915-8939
Mailing Address - Fax:412-436-2707
Practice Address - Street 1:1789 S BRADDOCK AVE STE 410
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1881
Practice Address - Country:US
Practice Address - Phone:412-915-8939
Practice Address - Fax:412-436-2707
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010823101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25844246Medicaid