Debra L Roberts, LADC, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089-0000521 Issued in VT

Practice address

128 Merchants Row
Suite 611- 612
Rutland, VT 05701-5911

Phone

(802) 786-8008

Fax

(802) 786-8008

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Ms. Debra L Roberts Former name

Medicare fee-for-service enrollment

Enrolled in VT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506038400000",
    "number": "1043384787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MERCHANTS ROW",
            "address_2": "SUITE 611- 612",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057015911",
            "telephone_number": "802-786-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MERCHANTS ROW",
            "address_2": "SUITE 611- 612",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057015911",
            "telephone_number": "802-786-8008",
            "fax_number": "802-786-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DEBRA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LADC, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2017-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "000207",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0000521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "364282",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2172180",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS,BLUE SHIELD",
            "identifier": "59865",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEAMSTERS BEHAV. HEALTH",
            "identifier": "115219",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010145",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "589706000",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "ROBERTS",
            "middle_name": "L",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• RJW Inc
• RJW Inc
• Robert a Hiller LTD
• Michael E Robertello, M.D.
• Barbara Roberts, LCMHC
• James W Roberts, MD
• Danielle M Robillard, APRN
• Mary Ellen Robinson, NP
• Tais Rodrigues Torezan
• Martin Andres Rodriguez Wong

• Clinical Social Worker in Rutland, VT
• Providers in Rutland, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.

Verify at the official NPI Registry.