Individual
CHARLES ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 865-1719
(228) 865-1780
Mailing address
PO BOX 134, BILOXI, MS 39533-0134
(228) 232-1556
(228) 865-1780
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
C10483
MS
Other
Enumeration date
01/30/2019
Last updated
07/29/2024
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