Provider Demographics
NPI:1871174920
Name:ROBERTSON, LAUREN EMILY (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:EMILY
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:EMILY
Other - Last Name:RIZZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:PO BOX 1278
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28093-1278
Mailing Address - Country:US
Mailing Address - Phone:800-491-5369
Mailing Address - Fax:301-774-3678
Practice Address - Street 1:17826 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:ASHTON
Practice Address - State:MD
Practice Address - Zip Code:20861-9781
Practice Address - Country:US
Practice Address - Phone:800-491-5369
Practice Address - Fax:301-774-3678
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD265381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical