Misty Roeder, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

255040 Issued in KY

Practice address

100 Executive Park Ste 103
Louisville, KY 40207-4201

Phone

(888) 585-8434

Fax

(216) 456-8128

NPI assigned

Apr 25, 2012

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 KY

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

Telehealth

Offers telehealth services

Group practices

Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

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.

• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713

  Clinical, KY

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1598023731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "888-585-8434",
            "fax_number": "216-456-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EXECUTIVE PARK STE 103",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074201",
            "telephone_number": "888-585-8434",
            "fax_number": "216-456-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEDER",
        "first_name": "MISTY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY SOCIAL WORK BOARD LCSW",
            "identifier": "255040",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100679350",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Roe, CF-SLP
• Allison C Roe, M.S. CCC/SLP
• Amy Joelle Roe, PAC
• Tambra Roe, P.T.
• Helen Elizabeth Roebker
• Lindsey Roederer
• Madison L Roehrs
• Alisha Nicole Roethemeyer, APRN
• Ignacio Roger de Ona, MD
• Rogers at Home Inc

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.