Individual provider Active NPI

Phillip Adam Roberto, MSW, LISW

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1306217633
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1700649 Issued in OH
Practice address
4240 Airport Rd Ste 205
Cincinnati, OH 45226-1622
Phone
(513) 289-8151
NPI assigned
Oct 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1700649 OH Primary

Addresses

Primary practice location

4240 Airport Rd Ste 205
Cincinnati, OH 45226-1622

Mailing address

4240 Airport Rd Ste 205
Cincinnati, OH 45226-1622
Phone (513) 289-8151

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1700649OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1306217633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 AIRPORT RD STE 205",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452261622",
            "telephone_number": "513-289-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 AIRPORT RD STE 205",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452261622",
            "telephone_number": "513-289-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTO",
        "first_name": "PHILLIP",
        "middle_name": "ADAM",
        "credential": "MSW, LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-13",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.