Individual provider Active NPI

Kayla Emely Roberts

  • Clinical Social Worker
  • Coldwater, MI
National Provider Identifier
1073196200
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801116491 Issued in MI
Practice address
200 Vista Dr
Coldwater, MI 49036-1776
Phone
(517) 278-2129
NPI assigned
May 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 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 6801116491 MI Primary

Addresses

Primary practice location

200 Vista Dr
Coldwater, MI 49036-1776

Mailing address

357 S Matteson St
Bronson, MI 49028-1512
Phone (517) 617-5151

Other practice location 1

28 W Chicago St Ste 3E
Coldwater, MI 49036-1678
Phone (517) 617-5151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20230601001047 MI Practitioner - Clinical Social Worker 7113384447 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Branch County Community Mental Health AuthorityGroup PAC ID 4789612714, 12 clinicians

Practice addresses (Care Compare)

200 Vista Dr
Coldwater, MI 49036-1776
Phone (517) 278-2129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801116491MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roberts Counseling Services, PLLC Clinical CurrentSince Dec 22, 2024 Accepting new patients
Community Health Center of Branch County Current Accepting new patients
Branch County Community Mental Health Authority CurrentSince Jun 20, 2024 Accepting new patients
Regio T Penna MD, PC Current Accepting new patients
Community Health Center of Branch County Current Accepting new patients
Community Health Center of Branch County CurrentSince Jan 13, 2024 Accepting new patients
Community Health Center of Branch County CurrentSince Jan 13, 2024 Accepting new patients
John S Hand PHD PC & Associates PastSince Jul 23, 2023 Accepting new patients

Locations

200 Vista Dr
Coldwater, MI 49036
Phone (517) 278-2129

274 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5400

28 W Chicago St
Ste 3E
Coldwater, MI 49036
Phone (517) 617-5151

Organizations & group practices 8

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": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1073196200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 S MATTESON ST",
            "city": "BRONSON",
            "state": "MI",
            "postal_code": "490281512",
            "telephone_number": "517-617-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VISTA DR",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490361776",
            "telephone_number": "517-278-2129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 W Chicago St Ste 3E",
            "address_purpose": "LOCATION",
            "city": "Coldwater",
            "state": "MI",
            "postal_code": "490361678",
            "country_code": "US",
            "telephone_number": "517-617-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KAYLA",
        "middle_name": "EMELY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801116491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, MI

Sources for this page

Verify at the official NPI Registry.