Individual provider Active NPI

Roberta Van Dusen, LCSW

  • Mental Health Counselor
  • Rockledge, FL
National Provider Identifier
1033468913
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW4263 Issued in FL
Practice address
1770 Cedar St
Rockledge, FL 32955-3133
Phone
(321) 890-1500
NPI assigned
Sep 6, 2012
Last updated
Dec 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW4263 FL
Mental Health Counselor 101YM0800X SW4263 FL Primary

Addresses

Primary practice location

1770 Cedar St
Rockledge, FL 32955-3133

Mailing address

400 East Sheridan Rd
Melbourne, FL 32901-3122
Phone (321) 722-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170922000786 FL Practitioner - Clinical Social Worker 9032245402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Circles of Care IncGroup PAC ID 8729069380, 26 clinicians

Practice addresses (Care Compare)

1770 Cedar St
Rockledge, FL 32955-3133
Phone (407) 634-6264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Circles of Care, Inc. CurrentSince Jul 17, 2017 Accepting new patients
Circles of Care, Inc. CurrentSince Jul 17, 2017 Accepting new patients

Locations

400 Sheridan Rd
Melbourne, FL 32901
Phone (321) 722-5273

1770 Cedar St
Rockledge, FL 32955
Phone (321) 634-6257

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1033468913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST SHERIDAN RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013122",
            "telephone_number": "321-722-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 CEDAR ST",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553133",
            "telephone_number": "321-890-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DUSEN",
        "first_name": "ROBERTA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4263",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW4263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

Verify at the official NPI Registry.