Active NPI
Robert Tom Rollis III, LPC
- Professional Counselor
- Lansing, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401018728
- Practice address
- 4136 Legacy Pkwy
Lansing, MI 48911-4265 - Phone
- (928) 771-3544
- NPI assigned
- Mar 21, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 12618 | AZ | |
| Professional Counselor | 101YP2500X | 6401018728 | MI | Primary |
Addresses
Primary practice location
4136 Legacy Pkwy
Lansing, MI 48911-4265
Mailing address
2301 Meadowcroft Dr
Lansing, MI 48912-3517
Phone (928) 830-2575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12800 Escanaba Dr
Suite D
Dewitt, MI 48820-8680
Phone (517) 449-4162
1400 Abbot Rd
Suite 400
East Lansing, MI 48823-1900
Phone (517) 882-3732
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12618 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downriver Mental Health Clinic PC | Professional | Current | Accepting new patients |
| Kairos Counseling and Wellness | Current | Accepting new patients | |
| Downriver Mental Health Clinic PC | Current | Accepting new patients |
Locations
12800 Escanaba Dr
Ste D
Dewitt, MI 48820
Phone (517) 449-4162
1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787
4136 Legacy Pkwy
Lansing, MI 48911
Phone (517) 492-0517
1701 Lake Lansing Rd
Ste 120
Lansing, MI 48912
Phone 8104947180 ext. 106
Organizations & group practices 3
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.
-
- Psychologist
- Taylor, MI
- NPI 1295866135
-
- Clinical Social Worker
- Dewitt, MI
- NPI 1447977467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645228800000",
"number": "1710158308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 MEADOWCROFT DR",
"city": "LANSING",
"state": "MI",
"postal_code": "489123517",
"telephone_number": "928-830-2575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4136 LEGACY PKWY",
"city": "LANSING",
"state": "MI",
"postal_code": "489114265",
"telephone_number": "928-771-3544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLLIS",
"first_name": "ROBERT",
"middle_name": "TOM",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-21",
"last_updated": "2022-02-19",
"certification_date": "2022-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "12618",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401018728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.