Provider Demographics
NPI:1770696320
Name:ROBERTS, MARIELLA (LPCMH)
Entity type:Individual
Prefix:
First Name:MARIELLA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-0151
Mailing Address - Country:US
Mailing Address - Phone:302-652-2455
Mailing Address - Fax:302-322-6251
Practice Address - Street 1:1802 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3420
Practice Address - Country:US
Practice Address - Phone:302-652-2455
Practice Address - Fax:302-322-6251
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000368101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional