Individual provider Active NPI

Katherine Kristian Roberts, LISW-CP

  • Clinical Social Worker
  • Lexington, SC
National Provider Identifier
1356729693
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9650 Issued in SC
Practice address
518 E Main St Ste 8
Lexington, SC 29072-3668
Phone
(803) 528-8488
NPI assigned
May 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2015

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 9650 SC Primary

Addresses

Primary practice location

518 E Main St Ste 8
Lexington, SC 29072-3668

Mailing address

809 E Main St Apt 332
Lexington, SC 29072-3689
Phone (803) 528-8488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220506000463 SC Practitioner - Clinical Social Worker 9638556954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Future Psych Solutions, LLC 9 clinicians

Practice addresses (Care Compare)

1911 Gadsden St
Suite 101
Columbia, SC 29201-6400
Phone (803) 851-0642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9650SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Future Psych Solutions, LLC CurrentSince Apr 1, 2022 Accepting new patients
TMS Neurohealth South Carolina LLC CurrentSince Apr 1, 2022 Accepting new patients

Locations

1911 Gadsden St
Ste 101
Columbia, SC 29201
Phone (803) 335-5232

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1356729693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 E MAIN ST APT 332",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290723689",
            "telephone_number": "803-528-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 E MAIN ST STE 8",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290723668",
            "telephone_number": "803-528-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KATHERINE",
        "middle_name": "KRISTIAN",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "9650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.