Provider Demographics
NPI:1821762246
Name:ROBERTS, FAITH WANJA (LMLP, LMAC)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:WANJA
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LMLP, LMAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 NEW HAMPSHIRE ST STE C
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2774
Mailing Address - Country:US
Mailing Address - Phone:785-214-4012
Mailing Address - Fax:785-212-4015
Practice Address - Street 1:805 NEW HAMPSHIRE ST STE C
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2774
Practice Address - Country:US
Practice Address - Phone:785-214-4012
Practice Address - Fax:785-212-4015
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2672101YM0800X
KS690101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)