Provider Demographics
NPI:1518680131
Name:ROBERTS, LEAH ELAINE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:ELAINE
Last Name:ROBERTS
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 1:15212 WINSTEAD LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-5736
Mailing Address - Country:US
Mailing Address - Phone:240-460-9718
Mailing Address - Fax:
Practice Address - Street 1:7610 CARROLL AVE STE 310
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6315
Practice Address - Country:US
Practice Address - Phone:202-854-8343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500794811041C0700X
MD256531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical