Provider Demographics
NPI:1083445977
Name:ROBERTS, CHAUNTE (MA)
Entity type:Individual
Prefix:
First Name:CHAUNTE
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CHAUNTE
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10721 E JEFFERSON AVE UNIT 14122
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-7406
Mailing Address - Country:US
Mailing Address - Phone:248-919-8260
Mailing Address - Fax:
Practice Address - Street 1:16250 NORTHLAND DR STE 239
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5206
Practice Address - Country:US
Practice Address - Phone:313-731-2871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health