Provider Demographics
NPI:1689847410
Name:ROBERTS, CATHERINE ADLANDA (LCAS, LPC, CCS)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ADLANDA
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LCAS, LPC, CCS
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 1123
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-1123
Mailing Address - Country:US
Mailing Address - Phone:252-551-5544
Mailing Address - Fax:252-334-1598
Practice Address - Street 1:312 STERLINGWORTH ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-1724
Practice Address - Country:US
Practice Address - Phone:252-551-5544
Practice Address - Fax:252-334-1598
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-13
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7249101YM0800X
NC1232101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6112032Medicaid