Individual provider Active NPI

George Lee Roberson

  • Clinical Social Worker
  • Okeechobee, FL
National Provider Identifier
1730306473
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7712 Issued in FL
Practice address
304 NW 5TH St
Okeechobee, FL 34972-2565
Phone
(863) 610-0973
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW7712 FL Primary

Addresses

Primary practice location

304 NW 5TH St
Okeechobee, FL 34972-2565

Mailing address

275 SW 25TH St
Okeechobee, FL 34974-5802
Phone (863) 467-4836

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Behavioral Health Center Inc CurrentSince Sep 24, 2023 Accepting new patients
G & G Behavioral Health Service LLC Clinical Past Accepting new patients

Locations

304 NW 5th St
Okeechobee, FL 34972
Phone (863) 357-8268

304 NW 5th St
#300
Okeechobee, FL 34972
Phone (863) 357-8268

Organizations & group practices 2

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1730306473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SW 25TH ST",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349745802",
            "telephone_number": "863-467-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 NW 5TH ST",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349722565",
            "telephone_number": "863-610-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "GEORGE",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okeechobee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.