Kelli Ann Robertson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904009047 Issued in VA

Practice address

1761 Old Meadow Rd
MC Lean, VA 22102-4315

Phone

(703) 531-6334

NPI assigned

Jun 20, 2017

Sex

Female

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

Enrolled in VA

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Resilient Minds of Charlottesville

  • Clinical Social Worker
  • Charlottesville, VA
  • NPI 1083302533
  Medicare reassignment NPD Authorized official
• Rob Young, PSYD, BCB

  • Clinical Psychologist
  • Charlottesville, VA
  • NPI 1487197471
  NPD (past)

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497916800000",
    "number": "1548780786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 OLD MEADOW RD",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024315",
            "telephone_number": "703-531-6334",
            "fax_number": "703-448-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 OLD MEADOW RD",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024315",
            "telephone_number": "703-531-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2017-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Robbins, MD
• Raelyn Loiselle Roberson, PH.D.
• Robert a Comunale MD LTD
• Averill Roberto
• Anne Stuart Roberts, MD
• Melissa Leigh Robinson
• Robust Home Health Care Agency, LLC
• Danishia Rochester
• Diana Delvalle Rodriguez
• Thomas Roesel, M.D., PH.D.

• Clinical Social Worker in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.