Provider Demographics
NPI:1275610867
Name:ROBERTI, VIVIAN DANIEL (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:DANIEL
Last Name:ROBERTI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 KENILWORTH KNOLL
Mailing Address - Street 2:#313
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1882
Mailing Address - Country:US
Mailing Address - Phone:828-545-7284
Mailing Address - Fax:828-505-2870
Practice Address - Street 1:20 BATTERY PARK AVE.
Practice Address - Street 2:SUITE 604
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2522
Practice Address - Country:US
Practice Address - Phone:828-545-7284
Practice Address - Fax:828-505-2870
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0002551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2864840Medicare ID - Type Unspecified