Individual provider Active NPI

Roberta Jo Simons

  • Professional Counselor
  • Bridgeport, WV
National Provider Identifier
1275245367
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2693 Issued in WV
Practice address
65 Professional PL Ste 102103
Bridgeport, WV 26330-0258
Phone
(304) 848-5770
NPI assigned
Dec 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2693 WV Primary

Addresses

Primary practice location

65 Professional PL Ste 102103
Bridgeport, WV 26330-0258

Mailing address

65 Professional PL Ste 102103
Bridgeport, WV 26330-0258
Phone (304) 848-5770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20240112001407 WV Practitioner - Mental Health Counselor 2264883388 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care of West Virginia, Inc.Group PAC ID 0446232987, shared by 74 NPIs, 89 clinicians

Practice addresses (Care Compare)

597 Liberty St
West Milford, WV 26451-6801
Phone (304) 745-4568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia Inc CurrentSince Jan 1, 2024 Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia Inc Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. CurrentSince Jan 9, 2025 Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Community Care of West Virginia, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Current Accepting new patients
Community Care of West Virginia, Inc. Past Accepting new patients

Locations

65 Professional Pl
Ste 103
Bridgeport, WV 26330
Phone (304) 848-5770

6536 Main St
Jane Lew, WV 26378
Phone (304) 884-2307

249 Skidmore Ln
Sutton, WV 26601
Phone (304) 317-7275

133 Staunton Dr
Weston, WV 26452
Phone (304) 269-9510

Interoperability endpoints

  • Direct secure messaging: roberta.simons.1@4803.direct.athenahealth.com

Organizations & group practices 47

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.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1275245367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PROFESSIONAL PL STE 102103",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263300258",
            "telephone_number": "304-848-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PROFESSIONAL PL STE 102103",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263300258",
            "telephone_number": "304-848-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "ROBERTA",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.