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General NPI Number Information
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NPI Number | 1750048021
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Entity Type | Individual
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Provider Name | EVYAN ROBERTS LMSW, LGSW
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Gender | Female
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Dates
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Enumeration Date | 11/22/2021
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 1221 LOCUST ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5572
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Country | US
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Telephone | 202-503-4373
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 STIRLING RD
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City | SILVER SPRING
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State | MD
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Zip | 20901-2139
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Country | US
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Telephone | 301-442-2685
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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 | LG20000269
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 27948
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License Number State | MD
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