Provider Demographics
NPI:1043497704
Name:ROVARIS, JAMES MICHAEL (LCSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:ROVARIS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:ROVARIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:13237 ASHFORD PARK DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-4146
Mailing Address - Country:US
Mailing Address - Phone:719-238-4009
Mailing Address - Fax:919-841-4892
Practice Address - Street 1:13237 ASHFORD PARK DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-4146
Practice Address - Country:US
Practice Address - Phone:719-238-4009
Practice Address - Fax:919-841-4892
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6891041C0700X
NCC0078741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical