Provider Demographics
NPI:1407881329
Name:ROPER, GAY R (M ED, LCSW)
Entity Type:Individual
Prefix:
First Name:GAY
Middle Name:R
Last Name:ROPER
Suffix:
Gender:F
Credentials:M ED, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E CAMPBELL RD
Mailing Address - Street 2:STE 640
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-6703
Mailing Address - Country:US
Mailing Address - Phone:214-553-7205
Mailing Address - Fax:972-680-8608
Practice Address - Street 1:801 E CAMPBELL RD
Practice Address - Street 2:STE 640
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-6703
Practice Address - Country:US
Practice Address - Phone:214-553-7205
Practice Address - Fax:972-680-8608
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX051571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical