Individual provider Active NPI

Roberta Ann Colby

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1134435639
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2466 Issued in MN
Practice address
1129 Grand Ave
Saint Paul, MN 55105-2629
Phone
(651) 268-3252
NPI assigned
Aug 23, 2010
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2466 MN Primary

Addresses

Primary practice location

1129 Grand Ave
Saint Paul, MN 55105-2629

Mailing address

1129 Grand Ave
Saint Paul, MN 55105-2629
Phone (651) 444-5048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20240125002211 MN Practitioner - Marriage and Family Therapist 7214380385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
FamilymeansGroup PAC ID 9830085182, 12 clinicians

Practice addresses (Care Compare)

1129 Grand Ave
Saint Paul, MN 55105-2629
Phone (651) 439-4840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2466MNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Familymeans CurrentSince Jan 11, 2024 Accepting new patients

Locations

1129 Grand Ave
Saint Paul, MN 55105
Phone (651) 444-5051

1875 Northwestern Ave S
Stillwater, MN 55082
Phone (651) 439-4840

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1134435639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052629",
            "telephone_number": "651-444-5048",
            "fax_number": "651-641-8635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052629",
            "telephone_number": "651-268-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBY",
        "first_name": "ROBERTA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.