Provider Demographics
NPI:1699434514
Name:ROBERTS, KATHLEEN ANN (LMSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4C NORTH AVE STE 423
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2334
Mailing Address - Country:US
Mailing Address - Phone:410-449-4955
Mailing Address - Fax:
Practice Address - Street 1:4C NORTH AVE STE 423
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2334
Practice Address - Country:US
Practice Address - Phone:410-449-4955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical