Individual
TALIA LYNTASHA ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,LCSWA
Contact information
Practice address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Mailing address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P021304
NC
174400000X
Specialist
Primary
—
—
Other
Enumeration date
04/27/2021
Last updated
03/10/2026
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