Provider Demographics
NPI:1376661330
Name:ROBERTS, DAVID P (BS)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:P
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9175 W CEDAR DR
Mailing Address - Street 2:UNIT E
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-2870
Mailing Address - Country:US
Mailing Address - Phone:303-349-2604
Mailing Address - Fax:
Practice Address - Street 1:6700 W 44TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4732
Practice Address - Country:US
Practice Address - Phone:303-420-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor