Provider Demographics
NPI:1285090001
Name:CLAY WARD ROBERTS, LCSW
Entity type:Organization
Organization Name:CLAY WARD ROBERTS, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:WARD
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:225-937-8496
Mailing Address - Street 1:8752 QUARTERS LAKE RD
Mailing Address - Street 2:BUILDING #9
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-7306
Mailing Address - Country:US
Mailing Address - Phone:225-922-9122
Mailing Address - Fax:225-922-9125
Practice Address - Street 1:8752 QUARTERS LAKE RD
Practice Address - Street 2:BUILDING #9
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-7306
Practice Address - Country:US
Practice Address - Phone:225-922-9122
Practice Address - Fax:225-922-9125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA29291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty