Individual provider Active NPI

Chelsea Irena Roberts, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1619518883
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-12124 Issued in NM
Practice address
2600 Marble Ave NE
Albuquerque, NM 87106-2058
Phone
(505) 272-2207
NPI assigned
Sep 30, 2019
Last updated
Jun 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4246C AL
Clinical Social Worker 1041C0700X C-12124 NM Primary

Addresses

Primary practice location

2600 Marble Ave NE
Albuquerque, NM 87106-2058

Mailing address

2600 Marble Ave NE
Albuquerque, NM 87106-2058

Other practice location 1

109 Medical Park Dr Ste C
Andalusia, AL 36420-5364
Phone (334) 222-1818

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191127000049 AL Practitioner - Clinical Social Worker 7214360510
I20220816003661 NM Practitioner - Clinical Social Worker 7214360510 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4246CALMDClinical Social Worker
C-12124NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Hospital CurrentSince Jul 14, 2022 Accepting new patients
Cosby & Cosby Counseling & Consultation LLC Clinical CurrentSince Nov 4, 2019 Accepting new patients
Unm Hospital CurrentSince Jul 14, 2022 Accepting new patients
Unm Hospital Past Accepting new patients

Locations

109 Medical Park Dr
Ste C
Andalusia, AL 36420
Phone (334) 222-0019

614 W Bypass
Andalusia, AL 36420
Phone (334) 222-0119

2600 Marble Ave NE
Albuquerque, NM 87106
Phone (505) 272-2800

400 Tijeras Ave NW
Ste 450
Albuquerque, NM 87102
Phone (505) 272-0148

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1619518883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 MARBLE AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MARBLE AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062058",
            "telephone_number": "505-272-2207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Medical Park Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Andalusia",
            "state": "AL",
            "postal_code": "364205364",
            "country_code": "US",
            "telephone_number": "334-222-1818",
            "fax_number": "334-222-1919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CHELSEA",
        "middle_name": "IRENA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4246C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-12124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.