Kevin Robertson, PLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5019251006 Issued in MO

Practice address

318 N Main St
Maryville, MO 64468-1644

Phone

(660) 562-3000

Fax

(660) 562-3002

NPI assigned

Jun 19, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• New Beginnings Counseling Group

  • Social Worker
  • Maryville, MO
  • NPI 1336578442

  Addiction (Substance Use Disorder)

  NPD (past)
• New Beginnings Counseling Group Inc.

  • Psychologist
  • Maryville, MO
  • NPI 1154671311

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1336521947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 W EDWARDS ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682127",
            "telephone_number": "660-562-3000",
            "fax_number": "660-562-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644681644",
            "telephone_number": "660-562-3000",
            "fax_number": "660-562-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KEVIN",
        "credential": "PLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MO",
            "license": "5019251006",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "5019251006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reign Physical Therapy LLC
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• Darcy Richardson, DC
• Ileen Richey-Arellin, MSW LCSW
• Nolan A Ritzinger, PHARM.D
• Susan Lea Roecker, D.C.
• Taylor Rogers
• Abigail Ross, RDH
• Cindy Lea Rouner, BSED/MD, MSED, LMSW
• Theresa Ann Rowan, RPH

• Professional Counselor in Maryville, MO
• Providers in Maryville, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.