Active NPI
Cynthia Roberts, LCSW
- Clinical Social Worker
- Bartow, FL
National Provider Identifier
1104120450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW7765
- Practice address
- 1239 E Main St
Bartow, FL 33830-5058 - Phone
- (863) 519-0575
- NPI assigned
- Dec 30, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW7765 | FL | Primary |
Addresses
Primary practice location
1239 E Main St
Bartow, FL 33830-5058
Mailing address
PO Box 1559
Bartow, FL 33831-1559
Phone (863) 519-0575
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014153100 | Medicaid | FL |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW7765 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428883200000",
"number": "1104120450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1559",
"city": "BARTOW",
"state": "FL",
"postal_code": "338311559",
"telephone_number": "863-519-0575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1239 E MAIN ST",
"city": "BARTOW",
"state": "FL",
"postal_code": "338305058",
"telephone_number": "863-519-0575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "CYNTHIA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-30",
"last_updated": "2015-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW7765",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014153100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bartow, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.