Mary Lynn Roberts, M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A12103 Issued in NC

Practice address

1301 Carolina St
#114
Greensboro, NC 27401-1032

Phone

(920) 219-2307

NPI assigned

Jul 1, 2011

Sex

Female

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

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Restoration Place Ministries, Inc.

  • Professional Counselor
  • Greensboro, NC
  • NPI 1235528464
  NPD (past)

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1346537032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CAROLINA ST",
            "address_2": "#114",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011032",
            "telephone_number": "920-219-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 CAROLINA ST",
            "address_2": "#114",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011032",
            "telephone_number": "920-219-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A12103",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-21688",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ware Roberts, RN
• Karen Roberts
• Kenneth Barry Roberts, MD
• Ladawn Roberts, LCMHC-A
• Lindsay Gore Roberts, AGNP
• Ronald Wayne Roberts, MD
• Serena Roberts, PHARMD
• Valencia Roberts
• Roberts, Wallace & Associates PLLC
• Roberts, Wallace & Associates PLLC

• Mental Health Counselor in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.