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NPI Code Detail

MEDICARE: MARIKA ROBERTS LPC

MEDICARE: MARIKA ROBERTS LPC
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
1101YA0400XAddiction (Substance Use Disorder) CounselorPC007436PA
2101Y00000XCounselor

General Provider Information

NPI Number : 1790480093
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIKA ROBERTS LPC
Provider Business Mailing Address
First Line : 2185 W 8TH ST
Second Line :
City : ERIE
State : PA
Zip : 16505-4747
Country : US
Telephone Number : 814-453-5806
Fax Number :
Provider Business Practice Location Address
First Line : 2911 STATE ST
Second Line :
City : ERIE
State : PA
Zip : 16508-1831
Country : US
Telephone Number : 814-453-5806
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2023
Last Update Date : 11/14/2023

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