Provider Demographics
NPI:1861102972
Name:ROBERTS PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:ROBERTS PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORGIONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-848-8305
Mailing Address - Street 1:25 UNDERHILL RD
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482-1207
Mailing Address - Country:US
Mailing Address - Phone:203-491-0179
Mailing Address - Fax:
Practice Address - Street 1:25 UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1207
Practice Address - Country:US
Practice Address - Phone:203-491-0179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty