Provider Demographics
NPI:1255957478
Name:ROBERTS, ABRIANNA LATRICE (MSW, LCSW-A)
Entity type:Individual
Prefix:
First Name:ABRIANNA
Middle Name:LATRICE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7815 TIMBER COMMONS LN APT S
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-8632
Mailing Address - Country:US
Mailing Address - Phone:704-338-2745
Mailing Address - Fax:
Practice Address - Street 1:1126 SAM NEWELL RD STE C&D
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5083
Practice Address - Country:US
Practice Address - Phone:704-286-6227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0143901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical