Provider Demographics
NPI:1093895187
Name:ROBERTS, KAMI (LCSW-R)
Entity Type:Individual
Prefix:
First Name:KAMI
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2857 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3604
Mailing Address - Country:US
Mailing Address - Phone:718-265-4200
Mailing Address - Fax:718-265-8536
Practice Address - Street 1:2857 W 8TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3604
Practice Address - Country:US
Practice Address - Phone:718-265-4200
Practice Address - Fax:718-265-8536
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064176-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical