Thomas Edward Robertshaw, SSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

137653-3503 Issued in UT

Practice address

750 N 200 W
Provo, UT 84601-1677

Phone

(801) 373-4760

NPI assigned

Apr 15, 2009

Last updated

Apr 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Tom Robertshaw Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Wasatch Behavioral Health Special Service District

  • Clinical Medical Laboratory
  • Orem, UT
  • NPI 1669257556
  NPD
• Wasatch Behavioral Health Special Service District

  • Community/Behavioral Health Agency
  • Provo, UT
  • NPI 1356357115
  NPD (past)

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1619110053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD STE 300",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011690",
            "telephone_number": "801-373-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N 200 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSHAW",
        "first_name": "THOMAS",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "SSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-15",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "UT",
            "license": "SSW137653-3503",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "137653-3503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOM",
            "last_name": "ROBERTSHAW",
            "credential": "SSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carly Elizabeth Roberts
• Hayden Edward Roberts, SSW
• Hayley Elaine Roberts
• Sarah Roberts
• Tessa Marie Roberts
• Lindie A Robertson
• Sarah Robertson
• Taylor May Robertson
• Kipp Moreno Robins, MD
• Marc Sune Robins, DO

• Social Worker in Provo, UT
• Providers in Provo, UT by specialty
• Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.