Roberts, Stephen H

Roberts, Stephen H is an individual health care provider with primary practice located at 40 Camelot Drive , Fond Du Lac WI 54935. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Roberts, Stephen H can be contacted via phone (920) 907-8201.

Contact Information

Primary practice address
40 Camelot Drive Fond Du Lac WI 54935
Phone: (920) 907-8201
Fax: (920) 907-8209
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 672 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3105 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3105-123 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 672-132 Wisconsin

Profile Details

NPI number 1194891994
LBN Legal business name Roberts, Stephen H
Credentials LCSW, CSAC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2006
Last updated Apr 21st, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194891994 NPPES
Wisconsin MEDICAID 39307400

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