Provider Demographics
NPI:1487876934
Name:ROBERTS, JOHN STEVEN (LCSW, LSOTP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:STEVEN
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:LCSW, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 FM 32
Mailing Address - Street 2:PO BOX 1771
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-1746
Mailing Address - Country:US
Mailing Address - Phone:512-847-0951
Mailing Address - Fax:
Practice Address - Street 1:2400 FM 32
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-1746
Practice Address - Country:US
Practice Address - Phone:512-847-0951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS01276174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist