Provider Demographics
NPI:1659774404
Name:ROOP, JOHN F (LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:ROOP
Suffix:
Gender:M
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:PO BOX 8824
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-8824
Mailing Address - Country:US
Mailing Address - Phone:706-320-3770
Mailing Address - Fax:706-320-3772
Practice Address - Street 1:2000 16TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1665
Practice Address - Country:US
Practice Address - Phone:706-320-3770
Practice Address - Fax:706-320-3772
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2015-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003601101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional