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Individual

KIM LAND ROBERTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1511 JOHNSON FERRY RD STE 125, MARIETTA, GA 30062-6403
(770) 703-9031
(904) 337-0329
Mailing address
1801 BALDWIN FARMS DR, MARIETTA, GA 30068-1555
(770) 355-2381

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC008144
GA
101YM0800X
Mental Health Counselor
TPMC2681
FL
101YP2500X
Professional Counselor
Primary
LPC008144
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003170135A
GA
05
003170135C
GA
05
003170135F
GA
Enumeration date
11/05/2015
Last updated
10/18/2023
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