Active NPI
Norman Robertson
- Professional Counselor
- Sheridan, WY
National Provider Identifier
1033657432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC617
- Practice address
- 3322 Strahan Pkwy
Sheridan, WY 82801-9162 - Phone
- (307) 672-2044
- Fax
- (307) 674-6867
- NPI assigned
- Feb 6, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC617 | WY | Primary |
Addresses
Primary practice location
3322 Strahan Pkwy
Sheridan, WY 82801-9162
Mailing address
3322 Strahan Pkwy
Sheridan, WY 82801-9162
Phone (307) 672-2044
Other names 1
- Mark Robertson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC617 | WY | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Volunteers of America Northern Rockies | Current | Accepting new patients |
Locations
510 W 29th St
Cheyenne, WY 82001
Phone (307) 426-4728
3322 Strahan Pkwy
Sheridan, WY 82801
Phone (307) 638-8182
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 and National Provider Directory roles.
-
- Substance Abuse Rehabilitation Facility
- Sheridan, WY
- NPI 1689249682
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Torrington, WY
- NPI 1043459118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486339200000",
"number": "1033657432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3322 STRAHAN PKWY",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828019162",
"telephone_number": "307-672-2044",
"fax_number": "307-674-6867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3322 STRAHAN PKWY",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828019162",
"telephone_number": "307-672-2044",
"fax_number": "307-674-6867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "NORMAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-06",
"last_updated": "2017-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WY",
"license": "LPC617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARK",
"last_name": "ROBERTSON",
"credential": "LPC",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Sheridan, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.