Provider Demographics
NPI:1902047038
Name:ROBERTS, CLAUDIA JANE (MED, LPC)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:JANE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:MISS
Other - First Name:CLAUDIA
Other - Middle Name:JANE
Other - Last Name:HARTSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M ED LPC
Mailing Address - Street 1:108 LAKERIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:TX
Mailing Address - Zip Code:76108-9426
Mailing Address - Country:US
Mailing Address - Phone:817-237-5300
Mailing Address - Fax:
Practice Address - Street 1:108 LAKERIDGE RD
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:TX
Practice Address - Zip Code:76108-9426
Practice Address - Country:US
Practice Address - Phone:817-237-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6013101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional