Roach, Theodus Marques

Roach, Theodus Marques is an individual health care provider with primary practice located at 1408 E Franklin St , Monroe NC 28112-5160. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Roach, Theodus Marques can be contacted via phone (704) 635-2080.

Contact Information

Primary practice address
1408 E Franklin St Monroe NC 28112-5160
Phone: (704) 635-2080
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 65730 Texas
Behavioral Health & Social Service Providers / Clinical 1041C0700X C005319 North Carolina

Profile Details

NPI number 1154340768
LBN Legal business name Roach, Theodus Marques
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Sep 30th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154340768 NPPES
North Carolina MEDICAID 6106359

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