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General NPI Number Information
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NPI Number | 1366851362
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Entity Type | Individual
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Provider Name | ROBERTA BADILLO LSW, LGSW
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Gender | Female
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Dates
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Enumeration Date | 08/05/2014
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 2100 COMER AVE
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City | COLUMBUS
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State | GA
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Zip | 31904-8725
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Country | US
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Telephone | 706-325-1251
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Fax |
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Provider Business Mailing Address
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Address Line | 10 HIGHLAND AVE
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City | BEECH BOTTOM
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State | WV
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Zip | 26030-8725
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Country | US
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Telephone | 304-559-6171
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2512385
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License Number State | OH
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