Jermaine Tyron Robertson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8319 Issued in FL

Practice address

1512 Blountstown St
Tallahassee, FL 32304-1109

Phone

(850) 299-4991

NPI assigned

Jul 14, 2011

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

Credentials

Doctor of Philosophy

State licenses

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.

• Atunwa Psychological and Community Outreach Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tallahassee, FL
  • NPI 1053918292
  NPD Authorized official

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1407144124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15262",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323175262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 BLOUNTSTOWN ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323041109",
            "telephone_number": "850-299-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JERMAINE",
        "middle_name": "TYRON",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Holifield Roberts, PA-C
• Stephanie R Roberts, MSW
• Brianna Nicole Robertson
• Carla Janese Robertson, APRN
• Jarrod Robertson
• Lauren Robertson, COTA
• Mary Nylene Robertson, CRNA
• Natalie Robertson, PHARMD
• Summer Robertson, COTA/L
• Virginia Robertson

• Clinical Psychologist in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.