Provider Demographics
NPI:1922991553
Name:ROACH, NATHANIEL ARGIS STEVEN (LPC)
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:ARGIS STEVEN
Last Name:ROACH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 CHERWELL CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-1800
Mailing Address - Country:US
Mailing Address - Phone:361-834-7570
Mailing Address - Fax:
Practice Address - Street 1:11828 CANON BLVD STE H
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2554
Practice Address - Country:US
Practice Address - Phone:757-797-5371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014919101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty