Leslie Barbara Roberts

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6351004229 Issued in MI

Practice address

890 Washington Ave Ste 150
Holland, MI 49423-7731

Phone

(616) 460-0174

NPI assigned

Dec 19, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Leslie Barbara Bolt Professional name

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

West Michigan Psychological Services LLCGroup PAC ID 6103238167, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• West Michigan Psychological Services LLC

  • Mental Health Counselor
  • Holland, MI
  • NPI 1215407044

  Psychologist

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1265678338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 WASHINGTON AVE STE 150",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237731",
            "telephone_number": "616-460-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 WASHINGTON AVE STE 150",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237731",
            "telephone_number": "616-460-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LESLIE",
        "middle_name": "BARBARA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-19",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301012799",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6351004229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "BOLT",
            "middle_name": "BARBARA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gerald F Robbins, D.O.
• Robert Dale Renzema
• Jessica Roberts
• Jordyn Alexis Roberts, OTR/L
• Kristi Loraine Roberts, MA, LLPC
• Lindsay Kay Roberts, AU.D.
• Annette Robidoux
• Danielle Robinett, M.D.
• Harold Lincoln Robinson III, DMD
• Muriel Sara Robinson

• Psychologist in Holland, MI
• Providers in Holland, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.