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Organization
NICOLE DEROBERTIS, LCSW, LLC
Active
Organization
NICOLE DEROBERTIS, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE DEROBERTIS LCSW (OWNER)
(203) 644-0557
Entity
Organization
Contact information
Practice address
245 AMITY RD STE 209, WOODBRIDGE, CT 06525-2274
(203) 644-0557
(203) 504-7941
Mailing address
15A INDIAN RIDGE RD, YARMOUTH, ME 04096-7135
(203) 644-0557
(203) 504-7941
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007800
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008062842
—
CT
Enumeration date
11/12/2015
Last updated
09/08/2024
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