Daylen Cecil Roberts, LCSW
Social Worker, Clinical in Clearlake Oaks, CA. Individual provider (NPI-1).
NPI number1699102004
StatusActive
Last updated in NPPESNov 10, 2022
Details
- NPI
- 1699102004
- Entity type
- Individual (NPI-1)
- Name
- Daylen Cecil Roberts
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 30, 2013
- Certification date
- Nov 8, 2022
- Last updated
- Nov 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 107044 | CA | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | CSCR1003301852 | CA | |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | CCDS-R1003301852 | CA | |
| 1041C0700X | Social Worker, Clinical | ASW87243 | CA |
Practice location
14715 E. Highway 20Clearlake Oaks, CA 95458
Phone 707-989-1800 · Fax 707-998-0122
Mailing address
Po Box 316Lucerne, CA 95458-0316
Phone 707-274-5610 · Fax 707-006-1325
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