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General NPI Number Information
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NPI Number | 1235803156
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Entity Type | Individual
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Provider Name | LEANNE KATHERINE ROBERTS LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 270 FARMINGTON AVE STE 347
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City | FARMINGTON
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State | CT
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Zip | 06032-1986
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Country | US
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Telephone | 860-325-0522
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Fax |
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Provider Business Mailing Address
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Address Line | 30 ARROWHEAD DR
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City | NEW HARTFORD
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State | CT
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Zip | 06057-4101
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Country | US
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Telephone | 860-307-0924
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11611
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License Number State | CT
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