Alexis Marie Roberson, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC11386 Issued in MD

Practice address

216 E Cedar Hill LN
Brooklyn Park, MD 21225-3738

Phone

(412) 979-2554

NPI assigned

Jul 28, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Masterpeace Therapeutic Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1245996032
  NPD Authorized official
• Innovative Therapeutic Services, LLC

  • Mental Health Counselor
  • Laurel, MD
  • NPI 1003147505
  NPD (past)

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1255004925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 E CEDAR HILL LN",
            "city": "BROOKLYN PARK",
            "state": "MD",
            "postal_code": "212253738",
            "telephone_number": "412-979-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 E CEDAR HILL LN",
            "city": "BROOKLYN PARK",
            "state": "MD",
            "postal_code": "212253738",
            "telephone_number": "412-979-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "ALEXIS",
        "middle_name": "MARIE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC11386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Project Chesapeake LLC
• Project Chesapeake, LLC
• Project Chesapeake, LLC
• Regina Ann Puthen Purackal, PT
• Remedy Therapy
• Nichole Marie Rosado, RN, CNM
• Second Chance Behavioral Health Center LLC
• Second Chance Behavioral Health Center LLC
• Second Chance Behavioral Health Center LLC
• Harold Jacob Steadman IV

• Mental Health Counselor in Brooklyn Park, MD
• Providers in Brooklyn Park, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.