Provider Demographics
NPI:1518030477
Name:ROBERTS, ANN DENYSE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:DENYSE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, PLLC
Mailing Address - Street 1:18 EAST 48TH STREET
Mailing Address - Street 2:SUITE 1202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3019
Mailing Address - Country:US
Mailing Address - Phone:212-462-2868
Mailing Address - Fax:914-361-1917
Practice Address - Street 1:18 EAST 48TH STREET
Practice Address - Street 2:SUITE 1202
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10708
Practice Address - Country:US
Practice Address - Phone:212-462-2868
Practice Address - Fax:914-361-1917
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR 0441571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN4G922Medicare ID - Type Unspecified