Individual provider Active NPI

Virgil Everett Roberson, L.P., M.DIV.,M.A.

  • Psychoanalyst
  • New York, NY
National Provider Identifier
1699807164
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
000040-1 Issued in NY
Practice address
928 Broadway
Suite #600
New York, NY 10010-6008
Phone
(212) 581-5428
NPI assigned
Mar 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X 000040-1 NY Primary

Addresses

Primary practice location

928 Broadway
Suite #600
New York, NY 10010-6008

Mailing address

928 Broadway
Suite #600
New York, NY 10010-6008
Phone (212) 581-5428

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
000040-1NYMDPsychoanalyst

Practice roles

OrganizationSpecialtyStatusNew patients
The Counseling Center, Inc. Current Accepting new patients

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": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699807164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 BROADWAY",
            "address_2": "SUITE #600",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106008",
            "telephone_number": "212-581-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 BROADWAY",
            "address_2": "SUITE #600",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106008",
            "telephone_number": "212-581-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "VIRGIL",
        "middle_name": "EVERETT",
        "name_prefix": "Mr.",
        "credential": "L.P., M.DIV.,M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "000040-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.