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NPI Code Detail

MEDICARE: MISTY DAWN ROBERTS LPC, NCC

MEDICARE: MISTY DAWN ROBERTS LPC, NCC
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
1101YM0800XMental Health Counselor92281TX
2101YP2500XProfessional Counselor92281TX

General Provider Information

NPI Number : 1063232247
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISTY DAWN ROBERTS LPC, NCC
Provider Business Mailing Address
First Line : 1715 SANTA FE DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-6419
Country : US
Telephone Number : 682-719-2582
Fax Number :
Provider Business Practice Location Address
First Line : 1715 SANTA FE DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-6419
Country : US
Telephone Number : 682-719-2582
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2024
Last Update Date : 02/18/2026

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