Individual provider Active NPI

Richard Rhett Roberts, MSW, CADC

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1225547235
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
10564 SE Washington St
Portland, OR 97216-2809
Phone
(503) 228-9229
NPI assigned
Sep 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

10564 SE Washington St
Portland, OR 97216-2809

Mailing address

2620 NE Flanders St Unit 1
Portland, OR 97232-3158
Phone (818) 497-7457

Other practice location 1

1266 N Laurel Ave Apt 9
West Hollywood, CA 90046-5123
Phone (818) 497-7457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240829003777 OR Order and Referring Only - Clinical Social Worker 0244779585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Volunteers of America Inc. CurrentSince Jun 22, 2021 Accepting new patients

Locations

10564 SE Washington St
Portland, OR 97216
Phone (503) 228-9229

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225547235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 NE FLANDERS ST UNIT 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323158",
            "telephone_number": "818-497-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10564 SE WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162809",
            "telephone_number": "503-228-9229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1266 N Laurel Ave Apt 9",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900465123",
            "country_code": "US",
            "telephone_number": "818-497-7457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "RICHARD",
        "middle_name": "RHETT",
        "credential": "MSW, CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.