Active NPI
Robert Ronald Roberge, MSW
- Clinical Social Worker
- Iron Mountain, MI
National Provider Identifier
1659668556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801062050
- Practice address
- N3039 Quinnesec Lake Antoine Rd
Iron Mountain, MI 49801-9638 - Phone
- (906) 779-5893
- NPI assigned
- Jun 30, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801062050 | MI | Primary |
Addresses
Primary practice location
N3039 Quinnesec Lake Antoine Rd
Iron Mountain, MI 49801-9638
Mailing address
N3039 Quinnesec Lake Antoine Rd
Iron Mountain, MI 49801-9638
Phone (906) 779-5893
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 |
|---|---|---|---|
| 6801062050 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1659668556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N3039 QUINNESEC LAKE ANTOINE RD",
"city": "IRON MOUNTAIN",
"state": "MI",
"postal_code": "498019638",
"telephone_number": "906-779-5893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N3039 QUINNESEC LAKE ANTOINE RD",
"city": "IRON MOUNTAIN",
"state": "MI",
"postal_code": "498019638",
"telephone_number": "906-779-5893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERGE",
"first_name": "ROBERT",
"middle_name": "RONALD",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-30",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801062050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iron Mountain, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.