Provider Demographics
NPI:1053686576
Name:ROBERTS, EDWARD REED SR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:REED
Last Name:ROBERTS
Suffix:SR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 CANAL ST # 320
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6082
Mailing Address - Country:US
Mailing Address - Phone:504-483-1859
Mailing Address - Fax:504-483-7263
Practice Address - Street 1:3801 CANAL ST #320
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119
Practice Address - Country:US
Practice Address - Phone:504-483-7260
Practice Address - Fax:504-483-7263
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA86041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical