Active NPI
Kathleen Roberts, LCSW
- Clinical Social Worker
- Richmond, VA
National Provider Identifier
1114452786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904009892
- Practice address
- 5700 W Grace St
Suite 105-a
Richmond, VA 23226-1832 - Phone
- (804) 885-3748
- NPI assigned
- Apr 20, 2017
- 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 | 0904009892 | VA | Primary |
Addresses
Primary practice location
5700 W Grace St
Suite 105-a
Richmond, VA 23226-1832
Mailing address
5700 W Grace St
Suite 105-a
Richmond, VA 23226-1832
Phone (804) 885-3748
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Mind Health Center, LLC | Clinical | Past | Accepting new patients |
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.
-
- Clinical Social Worker
- Henrico, VA
- NPI 1336699461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600128000000",
"number": "1114452786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 W GRACE ST",
"address_2": "SUITE 105-A",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232261832",
"telephone_number": "804-885-3748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5700 W GRACE ST",
"address_2": "SUITE 105-A",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232261832",
"telephone_number": "804-885-3748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "KATHLEEN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-20",
"last_updated": "2020-09-15",
"certification_date": "2020-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904009892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.