Provider Demographics
NPI:1083258164
Name:ELIZABETH ROBERTS LLC
Entity Type:Organization
Organization Name:ELIZABETH ROBERTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:JONES
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:225-229-5034
Mailing Address - Street 1:4136 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-3820
Mailing Address - Country:US
Mailing Address - Phone:225-229-5034
Mailing Address - Fax:
Practice Address - Street 1:5160 S SHERWOOD FRST STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4898
Practice Address - Country:US
Practice Address - Phone:225-229-5034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty