Provider Demographics
NPI:1720802242
Name:ROARTY, JOANNE (LGPC)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:ROARTY
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7414 CHERRY TREE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1831
Mailing Address - Country:US
Mailing Address - Phone:240-299-0240
Mailing Address - Fax:
Practice Address - Street 1:7414 CHERRY TREE DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1831
Practice Address - Country:US
Practice Address - Phone:240-299-0240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLG14274101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor