Provider Demographics
NPI:1053060103
Name:ELIZABETH ROBERTS PSYCHOLOGY, P.C.
Entity Type:Organization
Organization Name:ELIZABETH ROBERTS PSYCHOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:VAIL
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:413-274-2393
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:WEST STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01266-0306
Mailing Address - Country:US
Mailing Address - Phone:413-274-2393
Mailing Address - Fax:413-353-5006
Practice Address - Street 1:69 CHURCH ST STE 4
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MA
Practice Address - Zip Code:01240-2540
Practice Address - Country:US
Practice Address - Phone:413-274-2393
Practice Address - Fax:413-353-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty