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NPI Code Detail

MEDICARE: LEIGH ROBERTS LCSW

MEDICARE: LEIGH ROBERTS LCSW
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
11041C0700XClinical Social Worker149.027387IL

General Provider Information

NPI Number : 1801699293
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEIGH ROBERTS LCSW
Provider Business Mailing Address
First Line : 3007 W LOGAN BLVD APT 3
Second Line :
City : CHICAGO
State : IL
Zip : 60647-1791
Country : US
Telephone Number : 740-438-7358
Fax Number :
Provider Business Practice Location Address
First Line : 3007 W LOGAN BLVD APT 3
Second Line :
City : CHICAGO
State : IL
Zip : 60647-1791
Country : US
Telephone Number : 740-438-7358
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2025
Last Update Date : 03/31/2025

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