Active NPI
Jaeden Marie Roberts, LICSW
- Clinical Social Worker
- Spokane, WA
National Provider Identifier
1043570146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW00006948
- Practice address
- 2017 W. 4TH Ave
Spokane, WA 99201 - Phone
- (504) 621-0359
- NPI assigned
- May 22, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW00006948 | WA | Primary |
Addresses
Primary practice location
2017 W. 4TH Ave
Spokane, WA 99201
Mailing address
2405 S Inland Empire Way
Spokane, WA 99224
Phone (504) 621-0359
Other names 1
- Janet Marie Roberts
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 12, 2024 through Dec 12, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW00006948 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1043570146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2405 S INLAND EMPIRE WAY",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99224",
"telephone_number": "504-621-0359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2017 W. 4TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99201",
"telephone_number": "504-621-0359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JAEDEN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-22",
"last_updated": "2024-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW00006948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JANET",
"last_name": "ROBERTS",
"middle_name": "MARIE",
"credential": "LICSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.