Individual provider Active NPI

Elizabeth Vail Roberts, PSYD

  • Clinical Neuropsychologist
  • Lenox, MA
National Provider Identifier
1184013427
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
012490 Issued in NY
Practice address
69 Church St Ste 4
Lenox, MA 01240-2540
Phone
(413) 274-2393
Fax
(413) 353-5006
NPI assigned
Jan 9, 2015
Last updated
Mar 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 012490 NY Primary

Addresses

Primary practice location

69 Church St Ste 4
Lenox, MA 01240-2540

Mailing address

PO Box 306
West Stockbridge, MA 01266-0306
Phone (413) 274-2393

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

LicenseStateTypeSpecialty
4783MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth Roberts Psychology, P.C. CurrentSince Mar 27, 2022 Accepting new patients
Williamstown Behavioral Health Associates PastSince Jan 5, 2020 Accepting new patients
Siracusa Associates Behavioral Health LLC Past Accepting new patients
Eriver Neurology of New York. LLC PastSince Nov 11, 2017 Accepting new patients

Locations

69 Church St
Ste 4
Lenox, MA 01240
Phone (413) 274-2393

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJIAAA

Organizations & group practices 4

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": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1184013427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "WEST STOCKBRIDGE",
            "state": "MA",
            "postal_code": "012660306",
            "telephone_number": "413-274-2393",
            "fax_number": "413-353-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 CHURCH ST STE 4",
            "city": "LENOX",
            "state": "MA",
            "postal_code": "012402540",
            "telephone_number": "413-274-2393",
            "fax_number": "413-353-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ELIZABETH",
        "middle_name": "VAIL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "012490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenox, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.