Provider Demographics
NPI:1891286357
Name:ROBERTS, JOANNA MARIA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:MARIA
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:JOANNA
Other - Middle Name:MARIA
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3190 RADIO ROAD PO BOX 112662
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32611-4100
Mailing Address - Country:US
Mailing Address - Phone:352-392-1575
Mailing Address - Fax:
Practice Address - Street 1:3190 RADIO RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-2519
Practice Address - Country:US
Practice Address - Phone:352-392-1575
Practice Address - Fax:352-392-5567
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15972101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health