Daylen Cecil Roberts, LCSW
Individual provider Active NPI Clinical Social Worker · Clearlake Oaks, CA
NPI 1699102004 · NPPES record last updated Nov 10, 2022
Key facts
- NPI
- 1699102004
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 107044 (CA)
- Practice address
- 14715 E. Highway 20
Clearlake Oaks, CA 95458 - Phone
- (707) 989-1800
- Fax
- (707) 998-0122
- NPI assigned
- Sep 30, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CCDS-R1003301852 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| CSCR1003301852 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| ASW87243 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hilltop Recovery Services | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CSCR1003301852 | CA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CCDS-R1003301852 | CA | |
| Clinical Social Worker | 1041C0700X | ASW87243 | CA | |
| Clinical Social Worker | 1041C0700X | 107044 | CA | Yes |
Addresses
Primary practice location
14715 E. Highway 20
Clearlake Oaks, CA 95458
Mailing address
PO Box 316
Lucerne, CA 95458-0316
Phone (707) 274-5610
Other providers in Clearlake Oaks, CA
- Janine Orri
- Aura Palma
- Patrick Steven Pearmain
- Potential Way
- Benjamin Chet Revis
- Rikki Irie Ruiz
- Patricia V Santacruz
- John Phillip Sheridan
- Darcy Towner Skarada
- Sean Sullivan
All providers in Clearlake Oaks, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.