Provider Demographics
NPI:1306529292
Name:ROBERTS, CLAYTON (LMSW)
Entity type:Individual
Prefix:MR
First Name:CLAYTON
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 CARPENTER HTS
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-6108
Mailing Address - Country:US
Mailing Address - Phone:203-443-0315
Mailing Address - Fax:
Practice Address - Street 1:285 NICOLL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2625
Practice Address - Country:US
Practice Address - Phone:203-606-2395
Practice Address - Fax:203-643-2499
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT83971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical