Provider Demographics
NPI:1851031454
Name:THOMAS ROBERTS, CLARICE (LMHC, CAP, CPP, RN)
Entity Type:Individual
Prefix:MS
First Name:CLARICE
Middle Name:
Last Name:THOMAS ROBERTS
Suffix:
Gender:F
Credentials:LMHC, CAP, CPP, RN
Other - Prefix:MS
Other - First Name:CLARICE
Other - Middle Name:T
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, CAP, CPP, RN
Mailing Address - Street 1:5144 ALDERBROOK PL
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-7644
Mailing Address - Country:US
Mailing Address - Phone:813-317-7991
Mailing Address - Fax:
Practice Address - Street 1:5144 ALDERBROOK PL
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-7644
Practice Address - Country:US
Practice Address - Phone:813-317-7991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7727101YM0800X, 101Y00000X
FL2318101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)