Individual provider Active NPI

Roberta Lou Allen, LMSW-ACP

  • Clinical Social Worker
  • Amarillo, TX
National Provider Identifier
1376628545
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12121 Issued in TX
Practice address
3131 Bell St Ste 110
Amarillo, TX 79106-5029
Phone
(806) 355-0515
Fax
(806) 355-0546
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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 12121 TX Primary

Addresses

Primary practice location

3131 Bell St Ste 110
Amarillo, TX 79106-5029

Mailing address

7 Canyon Rim Dr
Canyon, TX 79015-1719
Phone (806) 674-3338

Other identifiers 1

IdentifierTypeStateIssuer
063912201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120611000326 TX Practitioner - Clinical Social Worker 1850555400 Practice locations: Amarillo, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3131 Bell St
Suite 110
Amarillo, TX 79106-5029
Phone (806) 674-3338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12121TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1376628545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CANYON RIM DR",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790151719",
            "telephone_number": "806-674-3338",
            "fax_number": "806-655-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 BELL ST STE 110",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791065029",
            "telephone_number": "806-355-0515",
            "fax_number": "806-355-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "ROBERTA",
        "middle_name": "LOU",
        "credential": "LMSW-ACP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "12121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063912201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.