Provider Demographics
NPI:1659916773
Name:ROBERTS, JANUARY BRYER (LCPC)
Entity Type:Individual
Prefix:MS
First Name:JANUARY
Middle Name:BRYER
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5557 BALTIMORE AVE
Mailing Address - Street 2:500-1562
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-3934
Mailing Address - Country:US
Mailing Address - Phone:301-452-8561
Mailing Address - Fax:
Practice Address - Street 1:5557 BALTIMORE AVE
Practice Address - Street 2:500-1562
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-3934
Practice Address - Country:US
Practice Address - Phone:301-452-8561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC11322101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health