Provider Demographics
NPI:1447225073
Name:ROBERTS, VIRGINIA L (MS)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:L
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:GINNY
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8035 E CORTE DEL JAVEN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750
Mailing Address - Country:US
Mailing Address - Phone:520-722-8988
Mailing Address - Fax:520-722-8623
Practice Address - Street 1:5210 E PIMA
Practice Address - Street 2:STE 200
Practice Address - City:TUCSON
Practice Address - State:AS
Practice Address - Zip Code:85712
Practice Address - Country:US
Practice Address - Phone:520-325-5222
Practice Address - Fax:520-722-8623
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC1139101Y00000X, 103T00000X
AZLISAC0199101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist