Healthcare Provider Details

I. General information

NPI: 1740503556
Provider Name (Legal Business Name): KENNETH L ROBERTS LPCC,LCPC,LPC,LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2831 15TH ST NW
WASHINGTON DC
20009-4607
US

IV. Provider business mailing address

2831 15TH ST NW
WASHINGTON DC
20009-4607
US

V. Phone/Fax

Practice location:
  • Phone: 202-972-9873
  • Fax:
Mailing address:
  • Phone: 202-972-9873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1590
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number302801
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number200012606
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701014977
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2606573
License Number StateOH
# 6
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC16525
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: