Healthcare Provider Details

I. General information

NPI: 1982905550
Provider Name (Legal Business Name): HEATHER LYNN ROBERTS LCSW, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 ANDOVER RD
WESTBROOK ME
04092-3848
US

IV. Provider business mailing address

123 ANDOVER RD
WESTBROOK ME
04092-3848
US

V. Phone/Fax

Practice location:
  • Phone: 207-761-2200
  • Fax: 207-761-2108
Mailing address:
  • Phone: 207-761-2200
  • Fax: 207-761-2108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC5041
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC13652
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: