Individual
KATIE ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2701 12TH AVE S, FARGO, ND 58103-8753
(701) 451-4900
(651) 925-0057
Mailing address
2701 12TH AVE S, FARGO, ND 58103-8753
(701) 451-4900
(651) 925-0057
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
905-7-1-17-350
ND
101YP2500X
Professional Counselor
905-7-1-17A
ND
101YP2500X
Professional Counselor
SUP-LPCC-205
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1471638
—
ND
Enumeration date
07/13/2017
Last updated
01/13/2026
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