Individual provider Active NPI

Dale L Roberts, M.A.

  • Mental Health Counselor
  • Chapel Hill, NC
National Provider Identifier
1730377375
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6624 Issued in NC
Practice address
120 Providence Rd
Suite 102
Chapel Hill, NC 27514-2273
Phone
(919) 721-7320
Fax
(919) 498-6236
NPI assigned
Oct 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6624 NC Primary

Addresses

Primary practice location

120 Providence Rd
Suite 102
Chapel Hill, NC 27514-2273

Mailing address

860 Eagles Nest Dr
Sanford, NC 27332-8388
Phone (919) 498-6236

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
6624NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1730377375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 EAGLES NEST DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273328388",
            "telephone_number": "919-498-6236",
            "fax_number": "919-498-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROVIDENCE RD",
            "address_2": "SUITE 102",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142273",
            "telephone_number": "919-721-7320",
            "fax_number": "919-498-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DALE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "6624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.