MEDICARE: MRS. VIRGINIA L ROBERTS MS

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
1	101Y00000X	Counselor	LPC1139	AZ
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	LISAC0199	AZ
3	103T00000X	Psychologist	LPC1139	AZ

General Provider Information

NPI Number	:	1447225073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VIRGINIA L ROBERTS MS

Provider Business Mailing Address
First Line	:	8035 E CORTE DEL JAVEN
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750
Country	:	US
Telephone Number	:	520-722-8988
Fax Number	:	520-722-8623

Provider Business Practice Location Address
First Line	:	5210 E PIMA
Second Line	:	STE 200
City	:	TUCSON
State	:	AS
Zip	:	85712
Country	:	US
Telephone Number	:	520-325-5222
Fax Number	:	520-722-8623

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	09/11/2025

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