Individual provider Active NPI

Jessica Lyn Roberts, LCSWA

  • Clinical Social Worker
  • Sylva, NC
National Provider Identifier
1053205682
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P022164 Issued in NC
Practice address
1294 Savannah Dr
Sylva, NC 28779-7005
Phone
(828) 283-0235
NPI assigned
Jun 6, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P022164 NC Primary

Addresses

Primary practice location

1294 Savannah Dr
Sylva, NC 28779-7005

Mailing address

1294 Savannah Dr
Sylva, NC 28779-7005
Phone (828) 283-0235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P022164NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornbread & Roses Community Counseling Inc Clinical CurrentSince Jun 8, 2025 Accepting new patients

Locations

1294 Savannah Dr
Sylva, NC 28779
Phone (828) 283-0235

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1053205682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 SAVANNAH DR",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287797005",
            "telephone_number": "828-283-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 SAVANNAH DR",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287797005",
            "telephone_number": "828-283-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JESSICA",
        "middle_name": "LYN",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P022164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylva, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.