MEDICARE: KYRA ROBERTS LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker		MD

General Provider Information

NPI Number	:	1386511582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYRA ROBERTS LMSW

Provider Business Mailing Address
First Line	:	PO BOX 1382
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21203-1382
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4909 LIBERTY HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21207-8235
Country	:	US
Telephone Number	:	410-466-0127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	03/11/2026

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