Healthcare Provider Details

I. General information

NPI: 1992408413
Provider Name (Legal Business Name): CICELY ROBERTS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CENTERVIEW DR STE 150
VESTAVIA HILLS AL
35216-3749
US

IV. Provider business mailing address

2402 QUAIL CT
VESTAVIA HILLS AL
35216-5337
US

V. Phone/Fax

Practice location:
  • Phone: 205-807-5372
  • Fax:
Mailing address:
  • Phone: 561-376-8828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: