Healthcare Provider Details

I. General information

NPI: 1396194213
Provider Name (Legal Business Name): BARBARA T. ROBERTS, PHD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 06/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 CONNECTICUT AVE NW SUITE 5
WASHINGTON DC
20008-5700
US

IV. Provider business mailing address

4601 CONNECTICUT AVE NW SUITE 5
WASHINGTON DC
20008-5700
US

V. Phone/Fax

Practice location:
  • Phone: 202-304-1326
  • Fax: 202-291-2067
Mailing address:
  • Phone: 202-304-1326
  • Fax: 202-291-2067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberPSY1548
License Number StateDC

VIII. Authorized Official

Name: DR. BARBARA TAYLOR ROBERTS
Title or Position: OWNER/SOLE PROPRIETOR
Credential: PHD
Phone: 202-291-2137