Provider Demographics
NPI:1851496517
Name:ROBERTS, FRANK A (MSW LCSW)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:A
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9052 LORELEIGH WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031
Mailing Address - Country:US
Mailing Address - Phone:703-573-1399
Mailing Address - Fax:703-573-7445
Practice Address - Street 1:9052 LORELEIGH WAY
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:703-573-1399
Practice Address - Fax:703-573-7445
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040010091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0046496OtherMAGELLAN
05619805123POtherCAREL SD
05619805123POtherCAREL SD