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NPI Code Detail

MEDICARE: TIERRA ALEISHIA ROBERTS

MEDICARE: TIERRA ALEISHIA ROBERTS
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 Counselor0704018824VA

General Provider Information

NPI Number : 1396603536
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIERRA ALEISHIA ROBERTS
Provider Business Mailing Address
First Line : 1005 SOPHIA ST # 200
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-3809
Country : US
Telephone Number : 540-445-1803
Fax Number :
Provider Business Practice Location Address
First Line : 1005 SOPHIA ST # 200
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-3809
Country : US
Telephone Number : 540-445-1803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2026
Last Update Date : 01/15/2026

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Directions to “ TIERRA ALEISHIA ROBERTS ” Practice Location

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