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Individual
AMY RAYNELLE ROBERTS
Active
Individual
AMY RAYNELLE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSWA
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LMSW-44880
ID
104100000X
Social Worker
Primary
LMSW-44880
ID
1041C0700X
Clinical Social Worker
Primary
A17880
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/08/2022
Last updated
04/17/2026
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