Individual provider Active NPI

Melinda Godinez Roberson, LCSW

  • Clinical Social Worker
  • Sherwood, OR
National Provider Identifier
1306437769
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L8623 Issued in OR
Practice address
17197 SW Kinglet Dr
Sherwood, OR 97140-8195
Phone
(505) 463-5072
NPI assigned
Jan 28, 2021
Last updated
Jan 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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 L8623 OR Primary

Addresses

Primary practice location

17197 SW Kinglet Dr
Sherwood, OR 97140-8195

Mailing address

PO Box 1381
Sherwood, OR 97140-1381
Phone (505) 463-5072

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

State licenses

LicenseStateTypeSpecialty
L8623ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1306437769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1381",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971401381",
            "telephone_number": "505-463-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17197 SW KINGLET DR",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971408195",
            "telephone_number": "505-463-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODINEZ ROBERSON",
        "first_name": "MELINDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L8623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, OR

Sources for this page

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