Provider Demographics
NPI:1720755663
Name:ROBERTS, JANE MCCARTHY (LCSWA)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:MCCARTHY
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 PAVERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4710
Mailing Address - Country:US
Mailing Address - Phone:919-818-4284
Mailing Address - Fax:919-375-2061
Practice Address - Street 1:901 PAVERSTONE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4710
Practice Address - Country:US
Practice Address - Phone:428-491-9818
Practice Address - Fax:919-375-2061
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0167701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical