Michelle Robertson, CSUDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

9153574-6005 Issued in UT

Practice address

7601 S Redwood Rd
West Jordan, UT 84084-4007

Phone

(801) 233-8670

Fax

(801) 233-8682

NPI assigned

Sep 15, 2014

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Clinical Consultants Family Clinic

  • Family Medicine Physician
  • West Jordan, UT
  • NPI 1932837135
  NPD (past)

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1508267121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 S REDWOOD RD",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844007",
            "telephone_number": "801-233-8670",
            "fax_number": "801-233-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 S REDWOOD RD",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844007",
            "telephone_number": "801-233-8670",
            "fax_number": "801-233-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MICHELLE",
        "credential": "CSUDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "9153574-6005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306010574",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David S. Roberts, DDS
• Kaitlin Roberts
• Michael Roberts, DDS
• Stan Roberts, LMFT
• Christopher Robertson, PT
• Ashley Sara Robinson
• Hannah Robinson
• Stacy Robinson, SUDC
• Brandon J Robison
• Chelsea Robison

• Addiction (Substance Use Disorder) Counselor in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Addiction (Substance Use Disorder) Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.