Individual
BRETT REAGAN ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C., L.M.F.T.
Contact information
Practice address
4800 PLEASANT HILL DR, SUITE 201, ROANOKE, VA 24018-3406
(540) 989-1383
(540) 989-8092
Mailing address
4800 PLEASANT HILL DR, SUITE 201, ROANOKE, VA 24018-3406
(540) 904-6488
(540) 904-6482
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701001950
VA
106H00000X
Marriage & Family Therapist
Primary
0717000107
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038449
ANTHEM/BCBS
VA
Enumeration date
10/16/2006
Last updated
12/18/2012
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