Individual provider Active NPI

Jon Michael Robertson, LCSW

  • Clinical Social Worker
  • Pittsburgh, PA
National Provider Identifier
1629134879
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW014233 Issued in PA
Practice address
6324 Marchand St
Pittsburgh, PA 15206-4312
Phone
(412) 661-1239
Fax
(412) 661-1304
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW014233 PA Primary

Addresses

Primary practice location

6324 Marchand St
Pittsburgh, PA 15206-4312

Mailing address

808 N Grandview Ave
P.O. Box 3004
McKeesport, PA 15132-1602
Phone (412) 678-4039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW014233PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pittsburgh Pastoral Institute Clinical CurrentSince Jun 6, 2013 Accepting new patients

Locations

1025 Liverpool St
Pittsburgh, PA 15233
Phone 4126611239 ext. 226

6324 Marchand St
Pittsburgh, PA 15206

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1629134879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 N GRANDVIEW AVE",
            "address_2": "P.O. BOX 3004",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151321602",
            "telephone_number": "412-678-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 MARCHAND ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152064312",
            "telephone_number": "412-661-1239",
            "fax_number": "412-661-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JON",
        "middle_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.