Active NPI
Karlee Roberts, LMSW
- Clinical Social Worker
- Penn Yan, NY
National Provider Identifier
1639619026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.020814
- Practice address
- 418 N Main St
John D Kelly Behavioral Health
Penn Yan, NY 14527-1070 - Phone
- (315) 531-2400
- Fax
- (315) 531-2436
- NPI assigned
- Mar 3, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 098724-1 | NY | |
| Clinical Social Worker | 1041C0700X | 149.020814 | IL | Primary |
Addresses
Primary practice location
418 N Main St
John D Kelly Behavioral Health
Penn Yan, NY 14527-1070
Mailing address
418 N Main St
John D Kelly Behavioral Health
Penn Yan, NY 14527-1070
Phone (315) 531-2400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 098724-1 | NY | MD | Social Worker |
| 149.020814 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560297600000",
"number": "1639619026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "418 N MAIN ST",
"address_2": "JOHN D KELLY BEHAVIORAL HEALTH",
"city": "PENN YAN",
"state": "NY",
"postal_code": "145271070",
"telephone_number": "315-531-2400",
"fax_number": "315-531-2436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "418 N MAIN ST",
"address_2": "JOHN D KELLY BEHAVIORAL HEALTH",
"city": "PENN YAN",
"state": "NY",
"postal_code": "145271070",
"telephone_number": "315-531-2400",
"fax_number": "315-531-2436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "KARLEE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-03",
"last_updated": "2019-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "098724-1",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.020814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penn Yan, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.