Provider Demographics
NPI:1235803156
Name:ROBERTS, LEANNE KATHERINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:KATHERINE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06057-4101
Mailing Address - Country:US
Mailing Address - Phone:860-307-0924
Mailing Address - Fax:
Practice Address - Street 1:270 FARMINGTON AVE STE 347
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1986
Practice Address - Country:US
Practice Address - Phone:860-325-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT116111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical