Active NPI
Petronella I Roome Roberts, BA. MA.
- Mental Health Counselor
- Indianapolis, IN
National Provider Identifier
1306087341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1434 Shelby St
Indianapolis, IN 46203-1945 - Phone
- (317) 655-3218
- NPI assigned
- Mar 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1434 Shelby St
Indianapolis, IN 46203-1945
Mailing address
1434 Shelby St
Indianapolis, IN 46203-1945
Phone (317) 655-3218
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237680000000",
"number": "1306087341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1434 SHELBY ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462031945",
"telephone_number": "317-655-3218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1434 SHELBY ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462031945",
"telephone_number": "317-655-3218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOME ROBERTS",
"first_name": "PETRONELLA",
"middle_name": "I",
"name_prefix": "Mrs.",
"credential": "BA. MA.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-22",
"last_updated": "2009-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.