Creighton Roberts, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

APC005444 Issued in GA

Practice address

100 Mariners Dr Ste D
Kingsland, GA 31548-6667

Phone

(912) 510-0669

Fax

(912) 510-0754

NPI assigned

Aug 30, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1356897342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARINERS DR STE D",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486667",
            "telephone_number": "912-510-0669",
            "fax_number": "912-510-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARINERS DR STE D",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486667",
            "telephone_number": "912-510-0669",
            "fax_number": "912-510-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CREIGHTON",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-30",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC005444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert A Richards, PT
• Tonya Riley
• Angela Roberson
• Robert Houghteling, O.D., P.C.
• Robert J. Wilson, M.D., P.C.
• Judi Taylor Rogers, LCSW
• John Ross, LDO
• Sarah Roupp
• Ruxandra Mares, MD
• Martha Patricia Sanchez-Silva, M.D.

• Mental Health Counselor in Kingsland, GA
• Providers in Kingsland, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.