Individual provider Active NPI

Stephen M Roehm, LCSW

  • Clinical Social Worker
  • Henderson, KY
National Provider Identifier
1093009581
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3299 Issued in KY
Practice address
9619 Highway 1078 N
Henderson, KY 42420-9793
Phone
(812) 550-5154
NPI assigned
Jun 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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 3299 KY Primary

Addresses

Primary practice location

9619 Highway 1078 N
Henderson, KY 42420-9793

Mailing address

9619 Highway 1078 N
Henderson, KY 42420-9793
Phone (812) 550-5154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20161021001637 KY Practitioner - Clinical Social Worker 7214215409 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388620800000",
    "number": "1093009581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9619 HIGHWAY 1078 N",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424209793",
            "telephone_number": "812-550-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9619 HIGHWAY 1078 N",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424209793",
            "telephone_number": "812-550-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEHM",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-02",
        "last_updated": "2014-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, KY

Sources for this page

Verify at the official NPI Registry.