Provider Demographics
NPI:1407144009
Name:ROBERTS, CATHERINE (LPC)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 MOORE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CONLEY
Mailing Address - State:GA
Mailing Address - Zip Code:30288-1360
Mailing Address - Country:US
Mailing Address - Phone:404-455-0727
Mailing Address - Fax:877-665-6731
Practice Address - Street 1:4040 MOORE CREEK DR
Practice Address - Street 2:
Practice Address - City:CONLEY
Practice Address - State:GA
Practice Address - Zip Code:30288-1360
Practice Address - Country:US
Practice Address - Phone:404-455-0727
Practice Address - Fax:877-665-6731
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-16
Last Update Date:2011-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional