Individual provider Active NPI

Lauren Roberts, M.A.

  • Mental Health Counselor
  • Port Saint Lucie, FL
National Provider Identifier
1609988724
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH18650 Issued in FL
Practice address
1405 SE Goldtree Dr Ste Ad
Port Saint Lucie, FL 34952-7563
Phone
(217) 246-0766
NPI assigned
Aug 31, 2006
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH18650 FL Primary
Professional Counselor 101YP2500X 180-000972 IL

Addresses

Primary practice location

1405 SE Goldtree Dr Ste Ad
Port Saint Lucie, FL 34952-7563

Mailing address

1405 SE Goldtree Dr Ste C
Port Saint Lucie, FL 34952-7563
Phone (217) 246-0766

Other names 1

  • Ms. Lauren Roberts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • 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
I20241125000985 FL Practitioner - Mental Health Counselor 1153425749 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
180-000972ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Treatment Centers of America, LLC CurrentSince Sep 13, 2024 Accepting new patients
Treatment Centers of America, LLC CurrentSince Sep 13, 2024 Accepting new patients
Community Support Systems PastSince Mar 1, 2007 Accepting new patients
Coles County Mental Health Association, Inc Past Accepting new patients

Locations

318 S US Highway 1
Ste 205
Jupiter, FL 33477

1405 SE Goldtree Dr
Ste Ab
Port St Lucie, FL 34952
Phone (855) 700-0327

7330 Powell Rd
Wildwood, FL 34785
Phone (352) 352-6111

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1609988724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SE GOLDTREE DR STE C",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527563",
            "telephone_number": "217-246-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 SE GOLDTREE DR STE AD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527563",
            "telephone_number": "217-246-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH18650",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-000972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "ROBERTS",
            "prefix": "MS.",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.