Provider Demographics
NPI:1215785647
Name:ROBERTS, ALISSA (MA, LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MA, LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15534 PONDEROSA BEND DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-7346
Mailing Address - Country:US
Mailing Address - Phone:832-444-9998
Mailing Address - Fax:
Practice Address - Street 1:1610 WOODSTEAD CT STE 420
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3404
Practice Address - Country:US
Practice Address - Phone:281-363-4220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92766101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health