MEDICARE: MISS FAITH CHRISTIE LEIGH ROBY LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	1481	TN
2	101YM0800X	Mental Health Counselor
3	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1104386028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS FAITH CHRISTIE LEIGH ROBY LMFT

Provider Business Mailing Address
First Line	:	4646 POPLAR AVE STE 510
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4435
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4646 POPLAR AVE STE 510
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38117
Country	:	US
Telephone Number	:	901-264-0086
Fax Number	:	901-255-7733

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	06/08/2026

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