Provider Demographics
NPI:1366007544
Name:ROBERTS, DONALD PAUL (LAC)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:PAUL
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 383
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-0383
Mailing Address - Country:US
Mailing Address - Phone:406-550-1483
Mailing Address - Fax:
Practice Address - Street 1:42297 2ND AVE E
Practice Address - Street 2:
Practice Address - City:PABLO
Practice Address - State:MT
Practice Address - Zip Code:59855-7724
Practice Address - Country:US
Practice Address - Phone:406-332-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
MT37251101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No251B00000XAgenciesCase Management