Provider Demographics
NPI:1528150406
Name:ROBERTS, ROBERT G 'PETE' (MA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:G 'PETE'
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3511
Mailing Address - Country:US
Mailing Address - Phone:336-884-8526
Mailing Address - Fax:336-884-8526
Practice Address - Street 1:829 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3511
Practice Address - Country:US
Practice Address - Phone:336-884-8526
Practice Address - Fax:336-884-8526
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC203106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist