Resilient Minds of Charlottesville

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RESILIENT MINDS OF CHARLOTTESVILLE

Practice address

224 Carlton Rd
Charlottesville, VA 22902-5972

Phone

(434) 362-4443

NPI assigned

Apr 24, 2023

Organization subpart

No

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

Authorized official

Name

Kelli Robertson, LCSWNPI 1548780786

Title

Owner/Therapist

Phone

(434) 362-4443

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelli Ann Robertson, LCSW

  • Clinical Social Worker
  • McLean, VA
  • NPI 1548780786
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1083302533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 CARLTON RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025972",
            "telephone_number": "434-362-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 CARLTON RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025972",
            "telephone_number": "434-362-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT MINDS OF CHARLOTTESVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "434-362-4443",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Reon, M.D., PH.D.
• David R. Repaske, M.D.
• Lisa Repaske
• Dina Lynn Rephann, LPTA
• Christine Marlow Reppucci, PHD
• Resilient Nature LLC (Resilient Nature Therapy)
• Resilient Roots: Functional and Evolutionary Medicine
• Casey Resnick, MED, CCC-SLP
• Restoration and Hope House LLC
• Restorative Sleep Medicine

• Clinical Social Worker in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.