Jolene T Robertson, LCSW

Individual provider Active NPI Clinical Social Worker · W Lafayette, IN

NPI 1295064046 · NPPES record last updated Dec 8, 2009

Key facts

NPI
1295064046
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
34003762A (IN)
Practice address
2900 N River Rd
W Lafayette, IN 47906-3744
Phone
(765) 463-2555
NPI assigned
Dec 8, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34003762A IN Yes

Addresses

Primary practice location

2900 N River Rd
W Lafayette, IN 47906-3744

Mailing address

1626 Stanforth Ave
Lafayette, IN 47905-1962

Other providers in W Lafayette, IN

All providers in W Lafayette, IN · Clinical Social Worker in Indiana

Sources for this page

Verify at the official NPI Registry.