Stephenie Ann Roberts, LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1949 Issued in KS

Practice address

9505 W. Central
Ste. 103
Wichita, KS 67212-3832

Phone

(316) 721-0971

Fax

(316) 512-4070

NPI assigned

Jan 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Clinical Social Worker

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Change Your Life Enterprises, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Wichita, KS
  • NPI 1003895988

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1083693956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9505 W CENTRAL AVE",
            "address_2": "STE. 103",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123801",
            "telephone_number": "316-721-0971",
            "fax_number": "316-512-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9505 W. CENTRAL",
            "address_2": "STE. 103",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123832",
            "telephone_number": "316-721-0971",
            "fax_number": "316-512-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "STEPHENIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "1949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200277320A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremiah Roberts
• Kristin Onia Roberts
• Kylie Alexis Roberts
• Quentin Roberts
• Ryan Roberts, CRNA
• Tammy Jean Roberts, RPT
• Teffany Roberts
• Stephanie Anne Robertson-Cameron, DDS
• Amy Deanne Robertson, PHARMD
• Jeanette Michelle Robertson, PH.D., LCMFT

• Clinical Social Worker in Wichita, KS
• Providers in Wichita, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.