Provider Demographics
NPI:1336342054
Name:ROBERTS, JOHN LLOYD (PHD, LPC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:LLOYD
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 MILNER WAY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7326
Mailing Address - Country:US
Mailing Address - Phone:205-913-3563
Mailing Address - Fax:
Practice Address - Street 1:4041 MILNER WAY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-7326
Practice Address - Country:US
Practice Address - Phone:205-913-3563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2713101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional