Provider Demographics
NPI:1841544103
Name:ROBERTS, JAMES MELVILE (LCASA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MELVILE
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2537 CROSS POINT CIR APT 34
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-8354
Mailing Address - Country:US
Mailing Address - Phone:704-299-6713
Mailing Address - Fax:704-405-4262
Practice Address - Street 1:2537 CROSS POINT CIR APT 34
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-8354
Practice Address - Country:US
Practice Address - Phone:704-299-6713
Practice Address - Fax:704-405-4262
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2919A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)