Provider Demographics
NPI:1154463560
Name:ROBERTS, LINDA B (MED, LMHC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:B
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 PLAIN DR
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3962
Mailing Address - Country:US
Mailing Address - Phone:781-341-9939
Mailing Address - Fax:
Practice Address - Street 1:105 PLAIN DR
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3962
Practice Address - Country:US
Practice Address - Phone:781-341-9939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health