Provider Demographics
NPI:1942378203
Name:ROPER, MARY Q (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:Q
Last Name:ROPER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3700 BRIDGEWATER RD APT U4
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-4775
Mailing Address - Country:US
Mailing Address - Phone:706-324-5780
Mailing Address - Fax:
Practice Address - Street 1:5210 ARMOUR RD STE 200A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-5022
Practice Address - Country:US
Practice Address - Phone:706-576-6575
Practice Address - Fax:706-507-0590
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004034101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional