Michelle Lynn Roberts, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

69505 Issued in CA

Practice address

1563 Mission St Ste a
San Francisco, CA 94103

Phone

(628) 217-5200

Fax

(415) 553-3900

NPI assigned

May 24, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Michelle Lynn Waddell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• City & County of San Francisco

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Francisco, CA
  • NPI 1548379373
  NPD (past)

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1245523281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 MISSION ST STE A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032543",
            "telephone_number": "628-217-5200",
            "fax_number": "415-553-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 MISSION ST STE A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94103",
            "telephone_number": "628-217-5200",
            "fax_number": "415-553-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "69505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "WADDELL",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "M.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Isaac Roberts, NP
• Joseph Roberts
• Julie Roberts, MFT
• Laura Jessica Roberts, OTR/L
• Matthew George Roberts
• Molly Manning Roberts, MD, MS
• Robin D. Roberts, MD
• Ruth Armeda Roberts, PT
• Samantha Roberts, LCSW
• Thomas Kirby Roberts

• Clinical Social Worker in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.