Robert Josh Lydon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L7631 Issued in OR

Practice address

272 NW Medical Loop Ste E
Roseburg, OR 97471-5545

Phone

(541) 900-4285

Fax

(888) 810-2993

NPI assigned

Sep 7, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Roseburg Therapy LLC

  • Mental Health Counselor
  • Roseburg, OR
  • NPI 1538665013
  Medicare reassignment NPD Authorized official
• Adapt

  • Addiction (Substance Use Disorder) Counselor
  • Roseburg, OR
  • NPI 1720010549

  Mental Health

  Medicare reassignment NPD
• Adapt

  • Federally Qualified Health Center (FQHC)
  • Bandon, OR
  • NPI 1194529289
  NPD
• Adapt

  • Substance Abuse Rehabilitation Facility
  • Roseburg, OR
  • NPI 1649453440
  NPD

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1407137235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 NW MEDICAL LOOP STE E",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974715545",
            "telephone_number": "541-900-4285",
            "fax_number": "888-810-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 NW MEDICAL LOOP STE E",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974715545",
            "telephone_number": "541-900-4285",
            "fax_number": "888-810-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDON",
        "first_name": "ROBERT",
        "middle_name": "JOSH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-07",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500712185",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Marie Lundy, MD
• Elizabeth A Lupher, CADC-R
• Luxottica Retail North America Inc
• Yennhi Ly, PHARMD
• Gaylene Lyda, RNFA
• John William Lynch
• Cecelia Lynn
• Joshua Caleb Mabray, LPC
• Aaron Christopher Macarthur
• Esther Maccratic, PAC

• Clinical Social Worker in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.