Phyllis Marie Roberson, LPC, RN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6102263 Issued in NC

Practice address

401 Hillsborough St
Raleigh, NC 27603-1727

Phone

(919) 821-0790

Fax

(919) 861-8961

NPI assigned

Nov 1, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NC

  Medicare reassignment NPD
• Psych Support Inc.

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1699812651
  NPD (past)
• Triangle Family Services, Inc.

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1750423240
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1558448993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HILLSBOROUGH ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031727",
            "telephone_number": "919-821-0790",
            "fax_number": "919-861-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HILLSBOROUGH ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031727",
            "telephone_number": "919-821-0790",
            "fax_number": "919-861-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "PHYLLIS",
        "middle_name": "MARIE",
        "credential": "LPC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "6102263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102263",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC NURSING BOARD LICENSE",
            "identifier": "155657",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Jerry Robbins, DMD
• Aqueelah B Roberson, RN, DNP, FNP-C
• Carrie Elizabeth Roberson, LMFT
• Mary Elizabeth Roberson
• Patrick McQuown Roberson, DDS
• Salimah Roberson, PHLEBOTOMIST
• Sarah Roberson, PA
• Robert L Orander DDS PA
• Robert L Williamson III DDS 4 PA (Raleigh Comprehensive & Cosmetic Dentistry)
• Robert L Williamson III DDS PA (Raleigh Comprehensive & Cosmetic Dentistry)

• Mental Health Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.