Healthcare Provider Details

I. General information

NPI: 1316513468
Provider Name (Legal Business Name): ROBERTA RENEA JAMES LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 COMER AVE
COLUMBUS GA
31904-8725
US

IV. Provider business mailing address

2100 COMER AVE
COLUMBUS GA
31904-8725
US

V. Phone/Fax

Practice location:
  • Phone: 706-575-6796
  • Fax: 706-596-5727
Mailing address:
  • Phone: 706-575-6796
  • Fax: 706-596-5727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC014019
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: