Robert Benton Sivley III

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

256734 Issued in KY

Practice address

607 Hammond PLZ
Hopkinsville, KY 42240

Phone

(270) 881-9551

Fax

(270) 885-5871

NPI assigned

Mar 23, 2016

Last updated

Apr 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifeskills, Inc.

  dba Pennyroyal Center

  • Developmentally Disabled Services Day Training Agency
  • Hopkinsville, KY
  • NPI 1346321643
  NPD

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1720440217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 614",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422410614",
            "telephone_number": "270-886-2205",
            "fax_number": "270-886-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 HAMMOND PLZ",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "42240",
            "telephone_number": "270-881-9551",
            "fax_number": "270-885-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVLEY",
        "first_name": "ROBERT",
        "middle_name": "BENTON",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "256734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvette Simpson
• Paige Sims
• Ian Scott Sink, D.O.
• Sinking Fork Elementary School
• Robert B. Sivley Jr., PSY.D.
• Victoria Sledge
• Small Steps Developmental LLC
• Christy Dawn Smith Rojas
• Adrianna Smith
• Caroline C Smith, M.S., CCC

• Clinical Social Worker in Hopkinsville, KY
• Providers in Hopkinsville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.