Provider Demographics
NPI:1750427522
Name:WESTMORELAND, ROY ADAM (LPC-MHSP)
Entity type:Individual
Prefix:MR
First Name:ROY
Middle Name:ADAM
Last Name:WESTMORELAND
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-3738
Mailing Address - Country:US
Mailing Address - Phone:931-644-1752
Mailing Address - Fax:931-526-9925
Practice Address - Street 1:630 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-3738
Practice Address - Country:US
Practice Address - Phone:931-644-1752
Practice Address - Fax:931-526-9925
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1967101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ070056Medicaid
TN1512977Medicaid