Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

THEODUS MARQUES ROACH, LCSW

Active

Clinical Social Worker · INDIAN TRAIL, NC

Registration Details

NPI Number: 1154340768
Provider Type: Individual
Gender: Male
NPI Issued: Jul 18, 2006 (19.810747369094 yrs)
Last Updated: Feb 17, 2025
Licenses: 65730 (TX)

C005319 (NC)

Practice Information

Address: 210 POSTAGE WAY #1772

INDIAN TRAIL, NC, 280799701
Browse NC providers · Browse ZIP 28079
Phone: 9803385563
Fax: 7042280260
Primary Specialty: Clinical Social Worker
1041C0700X
Additional Specialty: Clinical Social Worker

Other Clinical Social Worker Providers in INDIAN TRAIL, NC

Name	Credential	NPI
MS. BEVERLY JEANNE WRIGHT	LCSW, CASAC, CEAP	1285742775
MR. JON WAYNE ECCLESTON II	LCSW	1306937750
DANIELLE TINA RICHARDSON	LCSW	1407003809
LINDELLY RAJO	LCSW	1124320676
MRS. ALICIA N RABINOWITZ	LCSW	1336566918
MRS. VANESSA STARR JAMES	LLMSW	1205213428

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.