Individual provider Active NPI

Christy Lentine Roberts, RN

  • Psychiatric/Mental Health Registered Nurse
  • Leesburg, VA
National Provider Identifier
1225773872
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
0001276039 Issued in VA
Practice address
19210 Greystone SQ
Leesburg, VA 20176-1278
Phone
(703) 955-0106
NPI assigned
Apr 28, 2022
Last updated
Apr 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 0001276039 VA Primary

Addresses

Primary practice location

19210 Greystone SQ
Leesburg, VA 20176-1278

Mailing address

19210 Greystone SQ
Leesburg, VA 20176-1278
Phone (703) 955-0106

Other identifiers 1

IdentifierTypeStateIssuer
0001276039OtherVAREGISTERED NURSE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL mindmirrorneurofeedback@gmail.com Direct

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001276039VAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1225773872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19210 GREYSTONE SQ",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201761278",
            "telephone_number": "703-955-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19210 GREYSTONE SQ",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201761278",
            "telephone_number": "703-955-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CHRISTY",
        "middle_name": "LENTINE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0001276039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "0001276039",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mindmirrorneurofeedback@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19210 Greystone Sq",
            "city": "Leesburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201761278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.