Roberts, Kim Land

Roberts, Kim Land is an sole proprietor health care provider with primary practice located at 1511 Johnson Ferry Rd Ste 125 , Marietta GA 30062-6403. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Roberts, Kim Land can be contacted via phone (770) 703-9031.

Contact Information

Primary practice address
1511 Johnson Ferry Rd Ste 125 Marietta GA 30062-6403
Phone: (770) 703-9031
Fax: (904) 337-0329
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LPC008144 Georgia
Behavioral Health & Social Service Providers / Mental Health 101YM0800X TPMC2681 Florida
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC008144 Georgia

Profile Details

NPI number 1891168373
LBN Legal business name Roberts, Kim Land
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 5th, 2015
Last updated Oct 18th, 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 1891168373 NPPES
Georgia MEDICAID 003170135C
Georgia MEDICAID 003170135F
Georgia MEDICAID 003170135A

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