Provider Demographics
NPI:1548561673
Name:ROBERTS, LACRESHA LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LACRESHA
Middle Name:LYNN
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 1:1905 STORMY CT
Mailing Address - Street 2:APT. 201
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-5197
Mailing Address - Country:US
Mailing Address - Phone:517-488-3466
Mailing Address - Fax:
Practice Address - Street 1:1905 STORMY CT
Practice Address - Street 2:APT. 201
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-5197
Practice Address - Country:US
Practice Address - Phone:517-488-3466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0138961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical