Healthcare Provider Details

I. General information

NPI: 1659288124
Provider Name (Legal Business Name): LAURA LEONARD ROBERTS M.S., ALC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 GREENHILL BLVD NW STE 155
FORT PAYNE AL
35967-8504
US

IV. Provider business mailing address

PO BOX 680271
FORT PAYNE AL
35968-1617
US

V. Phone/Fax

Practice location:
  • Phone: 256-410-2750
  • Fax:
Mailing address:
  • Phone: 205-382-0932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC06168
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: