Michelle N. Robertson, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP006205 Issued in GA

Practice address

125 Creekview TRL
Fayetteville, GA 30214-7229

Phone

(678) 764-8304

Fax

(866) 464-6131

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• LFS Speech-Language Services

  • Speech-Language Pathologist
  • Fayetteville, GA
  • NPI 1578583977
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164584702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 RUDGATE RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319042930",
            "telephone_number": "706-888-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CREEKVIEW TRL",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147229",
            "telephone_number": "678-764-8304",
            "fax_number": "866-464-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MICHELLE",
        "middle_name": "N.",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Victoria Roberts, PHARMD, RPH
• Marilyn Catherine Roberts, M.S. LPC
• Stacy D Roberts, B.S., D.C.
• Terrence Jawaan Roberts, O.D.
• Lavert None Robertson I, N.D.
• Anthony J Robinson, CSA
• Ariel Briana Robinson, RDN, LDN
• Aubrey Robinson
• Jonathan Alan Robinson, D.M.D.
• Peyton Rock

• Speech-Language Pathologist in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.