Provider Demographics
NPI:1538046073
Name:ROBERTS, JOSLYNNE (EDS, NCSP)
Entity type:Individual
Prefix:
First Name:JOSLYNNE
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 N ST
Mailing Address - Street 2:
Mailing Address - City:HEYBURN
Mailing Address - State:ID
Mailing Address - Zip Code:83336-8659
Mailing Address - Country:US
Mailing Address - Phone:706-405-9774
Mailing Address - Fax:
Practice Address - Street 1:1901 N ST
Practice Address - Street 2:
Practice Address - City:HEYBURN
Practice Address - State:ID
Practice Address - Zip Code:83336-8659
Practice Address - Country:US
Practice Address - Phone:706-405-9774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY82598103TS0200X
ID663329576103TS0200X
NE20230009501103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool