Provider Demographics
NPI:1639457088
Name:ROESLER, MAUREEN A (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:A
Last Name:ROESLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:A
Other - Last Name:ROESLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:1815 PLEASANT GROVE ROAD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72405-7870
Mailing Address - Country:US
Mailing Address - Phone:870-933-6886
Mailing Address - Fax:870-933-9395
Practice Address - Street 1:700 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3143
Practice Address - Country:US
Practice Address - Phone:870-425-1041
Practice Address - Fax:870-425-1049
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2205003101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARA1902031OtherMENTAL HEALTH COUNSELOR