Provider Demographics
NPI:1871351080
Name:ROBERTSON, JOYCE ANN (LPCC)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 RACE ST
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-2321
Mailing Address - Country:US
Mailing Address - Phone:440-243-5443
Mailing Address - Fax:
Practice Address - Street 1:398 W BAGLEY RD STE 216
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-1312
Practice Address - Country:US
Practice Address - Phone:216-340-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901508101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional