Provider Demographics
NPI:1710510623
Name:ROBA, BARBARA ANN (LMHC, CPC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:ROBA
Suffix:
Gender:F
Credentials:LMHC, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5640 SALT RD
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1359
Mailing Address - Country:US
Mailing Address - Phone:716-713-4384
Mailing Address - Fax:
Practice Address - Street 1:9680 COUNTY RD
Practice Address - Street 2:
Practice Address - City:CLARENCE CENTER
Practice Address - State:NY
Practice Address - Zip Code:14032-9240
Practice Address - Country:US
Practice Address - Phone:716-209-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005593-1101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional