Provider Demographics
NPI:1811247067
Name:BILOTTA, ROBYN M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:M
Last Name:BILOTTA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 BLACK ROCK TPKE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825
Mailing Address - Country:US
Mailing Address - Phone:203-275-8555
Mailing Address - Fax:203-612-9830
Practice Address - Street 1:1817 BLACK ROCK TPKE
Practice Address - Street 2:SUITE 102
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825
Practice Address - Country:US
Practice Address - Phone:203-275-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005824104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker