Roberto Carlos Antonetti, PHD, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

09645 Issued in TX

Practice address

3420 Oak Grove Ave
Dallas, TX 75204-2375

Phone

(214) 720-1833

Fax

(214) 979-0593

NPI assigned

Nov 1, 2006

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598842999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 OAK GROVE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042375",
            "telephone_number": "214-720-1833",
            "fax_number": "214-979-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 OAK GROVE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042375",
            "telephone_number": "214-720-1833",
            "fax_number": "214-979-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONETTI",
        "first_name": "ROBERTO",
        "middle_name": "CARLOS",
        "credential": "PHD, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "09645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP/CHIPS",
            "identifier": "10011049",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH STAR/VALUE OPTIONS",
            "identifier": "129486",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1585LC",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corinne Anton
• Jodi Antonelli, M.D.
• Maria Antonescu
• Alfredo Guillermo Antonetti, M.D.
• John William Antonetti, M.D.
• Antonio Roman, MD, PA
• Creshendle Antonio
• Alexandra Hope Antonioli, M.D., PH.D.
• Catherine Antony, D.O.
• Riya Antony, AU.D.

• Professional Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.