Provider Demographics
NPI:1780783803
Name:ROBERTSON, SCARLETT LEAS (DSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:SCARLETT
Middle Name:LEAS
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:DR
Other - First Name:SCARLETT
Other - Middle Name:LEAS
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DSW, LCSW
Mailing Address - Street 1:120 EAST 56 STREET SUITE 1040
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-9845
Mailing Address - Country:US
Mailing Address - Phone:917-940-5888
Mailing Address - Fax:
Practice Address - Street 1:120 EAST 56 STREET
Practice Address - Street 2:SUITE 1040
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-9845
Practice Address - Country:US
Practice Address - Phone:917-940-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0766301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical