Provider Demographics
NPI:1871669267
Name:ROBERTS, BETH M (LCSW)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:M
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 1:56 ARBOR ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-1201
Mailing Address - Country:US
Mailing Address - Phone:860-233-1345
Mailing Address - Fax:860-233-1346
Practice Address - Street 1:56 ARBOR ST
Practice Address - Street 2:SUITE 215
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1201
Practice Address - Country:US
Practice Address - Phone:860-233-1345
Practice Address - Fax:860-233-1346
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0047781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical