Joseph Charles Roberson, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1843 Issued in AZ

Practice address

11024 N 28TH Dr
Suite 290
Phoenix, AZ 85029-4377

Phone

(623) 486-0935

Fax

(602) 734-0692

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Jun 16, 2022 through Jun 16, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Roberson Clinical Services, LLC

  • Clinical Psychologist
  • Phoenix, AZ
  • NPI 1144614264
  Authorized official Same address or phone

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1467549071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7338 W COLUMBINE DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815353",
            "telephone_number": "623-776-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11024 N 28TH DR",
            "address_2": "SUITE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294377",
            "telephone_number": "623-486-0935",
            "fax_number": "602-734-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "JOSEPH",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "1843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Renee Robers, RD, CDCES
• Michael Vincent Robers, M.D.
• Roberson Clinical Services, LLC
• Angela Roberson, LCSW
• Frenita Roberson
• Kelly Ann Roberson, COTA/L
• Robert B Ogesen PC
• Robert Brems MD PC (Brems Eye Center)
• Robert E Raffel M D Inc
• Robert G Condra DO PC

• Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.