Healthcare Provider Details

I. General information

NPI: 1487348702
Provider Name (Legal Business Name): AMY MARIE ROBERTS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 POST RD
STEVENS POINT WI
54481-6458
US

IV. Provider business mailing address

2925 POST RD
STEVENS POINT WI
54481-6458
US

V. Phone/Fax

Practice location:
  • Phone: 715-340-8653
  • Fax:
Mailing address:
  • Phone: 715-340-8653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11953-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: