Provider Demographics
NPI:1225336068
Name:ROBERTS-ROSE, PATRICUA C (LCSW-C)
Entity Type:Individual
Prefix:
First Name:PATRICUA
Middle Name:C
Last Name:ROBERTS-ROSE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 W ROLLING CROSSROADS
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6280
Mailing Address - Country:US
Mailing Address - Phone:443-794-9310
Mailing Address - Fax:
Practice Address - Street 1:4 W ROLLING CROSSROADS
Practice Address - Street 2:SUITE 3
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6280
Practice Address - Country:US
Practice Address - Phone:443-794-9310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD119931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical