Active NPI
Ebony Dawn Robertson-Reed, MSW
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1700211174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW63917
- Practice address
- 526 S San Pedro St
Los Angeles, CA 90013-2102 - Phone
- (213) 488-9559
- NPI assigned
- Sep 4, 2013
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | ASW63917 | CA | Primary |
Addresses
Primary practice location
526 S San Pedro St
Los Angeles, CA 90013-2102
Mailing address
526 S San Pedro St
Los Angeles, CA 90013-2102
Phone (213) 488-9559
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 |
|---|---|---|---|
| ASW63917 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lamp Inc | Past | 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.
-
- Case Management Agency
- Los Angeles, CA
- NPI 1043344054
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415577600000",
"number": "1700211174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "526 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132102",
"telephone_number": "213-488-9559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "526 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132102",
"telephone_number": "213-488-9559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON-REED",
"first_name": "EBONY",
"middle_name": "DAWN",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-04",
"last_updated": "2014-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW63917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.