Provider Demographics
NPI:1881036127
Name:ROBERTS, SUZANNE KAY (LSW)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:KAY
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:KAY
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:122 ELMIRA ST., SUITE B
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:PA
Mailing Address - Zip Code:16947
Mailing Address - Country:US
Mailing Address - Phone:570-529-6060
Mailing Address - Fax:570-529-6069
Practice Address - Street 1:122 ELMIRA ST., SUITE B
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:PA
Practice Address - Zip Code:16947
Practice Address - Country:US
Practice Address - Phone:570-529-6060
Practice Address - Fax:570-529-6069
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor