Provider Demographics
NPI:1245897776
Name:ROBERTORY, SUSAN MORRIS (MSW, LICSW, LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:MORRIS
Last Name:ROBERTORY
Suffix:
Gender:F
Credentials:MSW, LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9117 KRISTIN LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-1424
Mailing Address - Country:US
Mailing Address - Phone:703-426-0577
Mailing Address - Fax:
Practice Address - Street 1:9117 KRISTIN LN
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-1424
Practice Address - Country:US
Practice Address - Phone:703-426-0577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty