Provider Demographics
NPI:1972334316
Name:ROBERTS, AUBREY HOPE (LPC/MHSP)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:HOPE
Last Name:ROBERTS
Suffix:
Gender:F
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 1:540 SID MARTIN RD APT 25
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-5111
Mailing Address - Country:US
Mailing Address - Phone:931-247-8095
Mailing Address - Fax:
Practice Address - Street 1:406 ROY MARTIN RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37615-2244
Practice Address - Country:US
Practice Address - Phone:423-212-3282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7316101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional