Alyssa Roberson, PSY.D.

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY004453 Issued in GA

Practice address

131 Canal St Ste D
Pooler, GA 31322-6019

Phone

(912) 988-3181

NPI assigned

Jun 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Georgia Outreach, LLC

  • Psychiatry Physician
  • Savannah, GA
  • NPI 1902128929
  NPD (past)

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1114594207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 CANAL ST STE D",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313226019",
            "telephone_number": "478-697-1458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 CANAL ST STE D",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313226019",
            "telephone_number": "912-988-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "ALYSSA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004453",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "GA",
            "license": "PSY004453",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "GA",
            "license": "PSY004453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Richards
• Shannon Arlene Riley
• Madison Riski, MS
• Anna Susan Rivera, LCSW
• Margie Ivette Rivera, CPHT
• Eva-Belle Roberts
• Jenay Latrice Roberts
• Alauna Robinson
• Sharon Robinson
• Melissa Robitaille, DPM

• Forensic Psychologist in Pooler, GA
• Providers in Pooler, GA by specialty
• Forensic Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.