Provider Demographics
NPI:1942571310
Name:ROBERTS, ALVITA LOUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALVITA
Middle Name:LOUISE
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 1:800 FLINTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3924
Mailing Address - Country:US
Mailing Address - Phone:919-616-6650
Mailing Address - Fax:
Practice Address - Street 1:800 FLINTWOOD CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3924
Practice Address - Country:US
Practice Address - Phone:919-616-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0075071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical