Mary Cecilia Robertson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

24311 Issued in TX

Practice address

6420 Southwest Blvd
Suite 112
Fort Worth, TX 76109

Phone

(817) 877-0033

Fax

(817) 877-0032

NPI assigned

Mar 19, 2008

Sex

Female

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)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1407027279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 ODESSA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761092219",
            "telephone_number": "817-877-0033",
            "fax_number": "817-877-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 SOUTHWEST BLVD",
            "address_2": "SUITE 112",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76109",
            "telephone_number": "817-877-0033",
            "fax_number": "817-877-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MARY",
        "middle_name": "CECILIA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "24311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana Robertson, M.D.
• Kate Lauren Robertson
• Kathleen Mary Robertson, MD
• Lauren Ashlee Robertson, PHARMD
• Margaret Robertson
• Paris Robertson
• Shannon Lea Robertson
• Taylor Robertson
• Rae Robinson Hubbard
• Abigail Elizabeth Robinson, MS, RDN, LD

• Clinical Psychologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.