Kimberly Ann Roberts, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

73-074559 Issued in NY

Practice address

1111 Elmwood Ave
Rochester, NY 14620

Phone

(585) 271-1209

Fax

(585) 241-1940

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kimberly Ann Dahl Former name

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Rochester Rehabilitation Center, Inc

  • Community/Behavioral Health Agency
  • Rochester, NY
  • NPI 1306901913
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1659588812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 ELMWOOD AVE",
            "city": "ROCHETSTER",
            "state": "NY",
            "postal_code": "14620",
            "telephone_number": "585-241-1209",
            "fax_number": "585-241-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14620",
            "telephone_number": "585-271-1209",
            "fax_number": "585-241-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73-074559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DAHL",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "LCSW-R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emma K Roberts, OT
• Harold John Roberts, OD
• Katherine Roberts, COTA
• Kathryn Roberts, AUD
• Kelsey Roberts, DC
• Mackenzie Roberts, PHARMD
• McKenzie Roberts, MHC-LP
• Renee Lynn Roberts, RPH
• Shartrice Roberts
• Skyler Roberts, CASAC

• Clinical Social Worker in Rochester, NY
• Providers in Rochester, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.