Active NPI
Nichol Kristen Roberts
- Marriage & Family Therapist
- Revere, MA
National Provider Identifier
1417206053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 360 Revere Beach Blvd
#316
Revere, MA 02151-4847 - Phone
- (978) 335-1097
- NPI assigned
- Aug 29, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
360 Revere Beach Blvd
#316
Revere, MA 02151-4847
Mailing address
360 Revere Beach Blvd
#316
Revere, MA 02151-4847
Phone (978) 335-1097
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1417206053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 REVERE BEACH BLVD",
"address_2": "#316",
"city": "REVERE",
"state": "MA",
"postal_code": "021514847",
"telephone_number": "978-335-1097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 REVERE BEACH BLVD",
"address_2": "#316",
"city": "REVERE",
"state": "MA",
"postal_code": "021514847",
"telephone_number": "978-335-1097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "NICHOL",
"middle_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Revere, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.