Individual
JESSICA V ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
232 CEDAR ST, NEW HAVEN, CT 06519-1610
(203) 503-3300
(203) 401-3352
Mailing address
400 COLUMBUS AVE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3174
(203) 503-3183
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10495
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
08/02/2016
Last updated
01/31/2019
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