Individual ProviderRoberta J De VitisCounselorBehavioral Health & Social Service ProvidersPractice Address727 N 182nd St, Suite 202, Shoreline, WA 98133-4402(206) 412-8943PECOS EnrollmentBased on the most recent information from CMS, provider Roberta J De Vitis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1437376290Provider TypeIndividualFull NameDe Vitis, Roberta JCredentialLMHCGenderFemaleSole ProprietorYesEnumeration Date4/20/2007Last Updated4/10/2024Contact InformationPractice LocationPractice Address727 N 182nd St, Suite 202, Shoreline, WA 98133-4402Phone(206) 412-8943Fax(206) 542-5235Mailing LocationMailing Address14041 25th Ave NE, Seattle, WA 98125-3411Phone(206) 412-8943Fax(206) 542-5235Provider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseLH00003452Washington