Roeback, Woodrow Anthony

Roeback, Woodrow Anthony is an sole proprietor health care provider with primary practice located at 1103 48Th Ave N Ste 201 , Myrtle Beach SC 29577-5418. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health, Managed Care Organizations / Exclusive Provider Organization. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Roeback, Woodrow Anthony can be contacted via phone (843) 501-1099.

Contact Information

Primary practice address
1103 48Th Ave N Ste 201 Myrtle Beach SC 29577-5418
Phone: (843) 501-1099
Fax: (843) 405-2040
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 9352 California
Behavioral Health & Social Service Providers / Mental Health 101YM0800X CP0182 Nevada
Behavioral Health & Social Service Providers / Professional 101YP2500X 12362 South Carolina
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 128746726004 Utah
Managed Care Organizations / Exclusive Provider Organization 302F00000X NV20131237531 Nevada

Profile Details

NPI number 1356681241
LBN Legal business name Roeback, Woodrow Anthony
Credentials CPC, CRC, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 1st, 2013
Last updated Jul 23rd, 2026 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356681241 NPPES
Other 15102754 CAQH

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