Individual provider Active NPI

Valerie N. Roberts, MSW, LCSW

  • Clinical Social Worker
  • Dixon, IL
National Provider Identifier
1548519192
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015740 Issued in IL
Practice address
403 E 1St St
Dixon, IL 61021-3116
Phone
(815) 285-5638
Fax
(815) 285-5850
NPI assigned
Aug 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149015740 IL Primary
Social Worker 104100000X

Addresses

Primary practice location

403 E 1St St
Dixon, IL 61021-3116

Mailing address

403 E 1St St
Dixon, IL 61021-3116
Phone (815) 285-5638

Other practice location 1

1901 1st Avenue
Sterling, IL 61081
Phone (815) 626-7333 ext. 302

Other identifiers 1

IdentifierTypeStateIssuer
F400356991OtherILMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20170124002810 IL Practitioner - Clinical Social Worker 1658653787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Roberts Counseling, PLLCGroup PAC ID 0648668764, 3 clinicians

Practice addresses (Care Compare)

114 E Everett St
Suite 209
Dixon, IL 61021-2181
Phone (563) 293-6917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149015740ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roberts Counseling, PLLC Clinical CurrentSince Aug 27, 2021 Accepting new patients
KSB Medical Group, Inc. Past Accepting new patients

Locations

114 E Everett St
Ste 209
Dixon, IL 61021
Phone (563) 293-6917

Organizations & group practices 2

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.

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": "1536278400000",
    "number": "1548519192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213116",
            "telephone_number": "815-285-5638",
            "fax_number": "815-285-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213116",
            "telephone_number": "815-285-5638",
            "fax_number": "815-285-5850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 1st Avenue",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "IL",
            "postal_code": "61081",
            "country_code": "US",
            "telephone_number": "815-626-7333 x302",
            "fax_number": "815-626-8752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "VALERIE",
        "middle_name": "N.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015740",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F400356991",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.