Individual provider Active NPI

Mary Robertson, LCSW

  • Clinical Social Worker
  • Montgomery, AL
National Provider Identifier
1396790473
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1603C Issued in AL
Practice address
1040 Longfield CT
Montgomery, AL 36117-8055
Phone
(334) 288-9009
Fax
(334) 288-9497
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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 1603C AL Primary

Addresses

Primary practice location

1040 Longfield CT
Montgomery, AL 36117-8055

Mailing address

1040 Longfield CT
Montgomery, AL 36117-8055
Phone (334) 288-9009

Other identifiers 1

IdentifierTypeStateIssuer
515 38765OtherALBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20040323000507 AL Practitioner - Clinical Social Worker 5597656231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
River Region Psychiatry Associates, LLCGroup PAC ID 1254491012, 118 clinicians

Practice addresses (Care Compare)

7125 University CT
Montgomery, AL 36117-8016
Phone (334) 239-2622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1603CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
River Region Psychiatry Associates LLC CurrentSince Jun 19, 2020 Accepting new patients
Alabama Psychiatric Services PC Past Accepting new patients

Locations

1000 1st St N
Alabaster, AL 35007
Phone (205) 620-8100

233 Winton M Blount Loop
Montgomery, AL 36117
Phone (334) 207-3188

7125 University Ct
Montgomery, AL 36117

333 Business Cir
Pelham, AL 35124
Phone (205) 255-3828

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1396790473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 LONGFIELD CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178055",
            "telephone_number": "334-288-9009",
            "fax_number": "334-288-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 LONGFIELD CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178055",
            "telephone_number": "334-288-9009",
            "fax_number": "334-288-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "1603C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "515 38765",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.