Provider Demographics
NPI:1952813651
Name:PAMELA ROBERTS LCSW
Entity Type:Organization
Organization Name:PAMELA ROBERTS LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:702-466-2552
Mailing Address - Street 1:6705 PAINTED CANYON CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-1685
Mailing Address - Country:US
Mailing Address - Phone:702-466-2552
Mailing Address - Fax:
Practice Address - Street 1:6705 PAINTED CANYON CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-1685
Practice Address - Country:US
Practice Address - Phone:702-466-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6571C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty