Individual provider Active NPI

Roberta Lynn Snow, LCSW, CCM

  • Social Worker
  • Oklahoma City, OK
National Provider Identifier
1215189980
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1539 Issued in OK
Practice address
4800 N Mayfair Dr
Oklahoma City, OK 73112-8209
Phone
(405) 702-1553
NPI assigned
Oct 14, 2008
Last updated
Apr 4, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1539 OK Primary
Clinical Social Worker 1041C0700X 1539 OK

Addresses

Primary practice location

4800 N Mayfair Dr
Oklahoma City, OK 73112-8209

Mailing address

4800 N Mayfair Dr
Oklahoma City, OK 73112-8209
Phone (405) 702-1553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20110323000664 OK Practitioner - Clinical Social Worker 8921083692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Oklahoma College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2516 NW 62ND St
Oklahoma City, OK 73112-7121
Phone (405) 650-9623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1539OKMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Transitions LLC CurrentSince Nov 12, 2015 Accepting new patients
Family Transitions LLC Past Accepting new patients
Revitalizing Hope, LLC Past Accepting new patients

Locations

4024 N Lincoln Blvd
Ste 2
Oklahoma City, OK 73105
Phone (405) 650-9623

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": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1215189980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N MAYFAIR DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731128209",
            "telephone_number": "405-702-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 N MAYFAIR DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731128209",
            "telephone_number": "405-702-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "ROBERTA",
        "middle_name": "LYNN",
        "credential": "LCSW, CCM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "1539",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "1539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.