Provider Demographics
NPI:1881453769
Name:NANETTE ROBERTO, LICSW
Entity type:Organization
Organization Name:NANETTE ROBERTO, LICSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:NANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:603-258-1875
Mailing Address - Street 1:103 ROXBURY ST STE 210
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3800
Mailing Address - Country:US
Mailing Address - Phone:603-258-1875
Mailing Address - Fax:
Practice Address - Street 1:103 ROXBURY ST STE 210
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3800
Practice Address - Country:US
Practice Address - Phone:603-258-1875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty