Provider Demographics
NPI:1811001134
Name:ROBERTS, STEPHEN E (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:E
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:STEPHEN
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:35 GROESBECK PL
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1121
Mailing Address - Country:US
Mailing Address - Phone:518-439-8686
Mailing Address - Fax:
Practice Address - Street 1:233 NEW SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3114
Practice Address - Country:US
Practice Address - Phone:518-533-2407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0146291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical