Provider Demographics
NPI:1902679210
Name:ROPER, TANYA RENEE (LCSW, LCDC)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:RENEE
Last Name:ROPER
Suffix:
Gender:F
Credentials:LCSW, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4456 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-5106
Mailing Address - Country:US
Mailing Address - Phone:432-770-9609
Mailing Address - Fax:
Practice Address - Street 1:4456 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-5106
Practice Address - Country:US
Practice Address - Phone:432-770-9609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1061691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical