Individual provider Active NPI

Warnie Mitchell (Mitch) Robertson, LICSW

  • Social Worker
  • Athens, AL
National Provider Identifier
1205915402
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LGSW Issued in AL
Practice address
600 S Clinton St
Athens, AL 35611-3506
Phone
(256) 850-4091
Fax
(256) 970-1643
NPI assigned
Nov 6, 2006
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LGSW AL Primary

Addresses

Primary practice location

600 S Clinton St
Athens, AL 35611-3506

Mailing address

PO Box 1289
Athens, AL 35612-1289
Phone (256) 874-4159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20110519000432 AL Practitioner - Clinical Social Worker 8426234808 Practice locations: Athens, AL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 S Clinton St
Athens, AL 35611-3506
Phone (256) 850-4091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGSWALMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Limestone Chiropractic Health Center P C CurrentSince Sep 12, 2021 Accepting new patients
T.H.E Social Work Services LLC PastSince Apr 6, 2011 Accepting new patients
Athens Eye Clinic, PC PastSince Sep 12, 2021 Accepting new patients

Locations

600 S Clinton St
Athens, AL 35611
Phone (256) 232-8240

Organizations & group practices 3

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1205915402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356121289",
            "telephone_number": "256-874-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S CLINTON ST",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356113506",
            "telephone_number": "256-850-4091",
            "fax_number": "256-970-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "WARNIE",
        "middle_name": "MITCHELL (MITCH)",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AL",
            "license": "LGSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, AL

Sources for this page

Verify at the official NPI Registry.