Marilyn J Roberts, LMSW
Individual provider Active NPI Social Worker · Park City, KS
NPI 1043415573 · NPPES record last updated Feb 21, 2025
Key facts
- NPI
- 1043415573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6910 (KS)
- Practice address
- 915 E 53Rd St N
Park City, KS 67219-2611 - Phone
- (316) 677-6746
- NPI assigned
- Jun 15, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6910 | KS | MD | Social Worker |
| 6657 | KS | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Word of Life Ministries and Schools Inc | Current |
Accepting new patients |
Locations
915 E 53rd St N
Park City, KS 67219
Phone (316) 677-6746
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6657 | KS | |
| Social Worker | 104100000X | 6910 | KS | Yes |
Addresses
Primary practice location
915 E 53Rd St N
Park City, KS 67219-2611
Mailing address
915 E 53Rd St N
Park City, KS 67219-2611
Phone (316) 677-6746
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013090489 | Medicaid | KS |
Other providers in Park City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.