Active NPI
Christopher Roberts, M.A.
- Clinical Social Worker
- Plymouth, MI
National Provider Identifier
1730586462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6401015235
- Practice address
- 9409 N Haggerty Rd
Plymouth, MI 48170-4696 - Phone
- (734) 559-3540
- NPI assigned
- Nov 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPCCCA00211319 | KY | |
| Professional Counselor | 101YP2500X | 6401015235 | MI | |
| Clinical Social Worker | 1041C0700X | 6401015235 | MI | Primary |
Addresses
Primary practice location
9409 N Haggerty Rd
Plymouth, MI 48170-4696
Mailing address
9409 N Haggerty Rd
Plymouth, MI 48170-4696
Phone (734) 559-3540
Other practice location 1
50430 School House Rd
Canton, MI 48187-5910
Phone (734) 495-1722
Other practice location 2
308 Barnes Rd
Williamstown, KY 41097-9483
Phone (859) 331-3292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 610661458 | Other | KY | TAX ID |
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, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
9409 N Haggerty Rd
Plymouth, MI 48170-4696
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCCCA00211319 | KY | MD | Professional Counselor |
| 6401015235 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Transformational Services LLC | Professional | Current | Accepting new patients |
| Growth Works Inc. | Past | Accepting new patients | |
| Growth Works, Inc | Past | Accepting new patients |
Locations
9409 N Haggerty Rd
Plymouth, MI 48170
Phone (734) 231-3933
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.
-
- Case Management Agency
- Plymouth, MI
- NPI 1386978385
-
- Addiction (Substance Use Disorder) Psychologist
- Plymouth, MI
- NPI 1851448146
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1730586462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9409 N HAGGERTY RD",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481704696",
"telephone_number": "734-559-3540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9409 N HAGGERTY RD",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481704696",
"telephone_number": "734-559-3540"
}
],
"practiceLocations": [
{
"address_1": "50430 School House Rd",
"address_purpose": "LOCATION",
"city": "Canton",
"state": "MI",
"postal_code": "481875910",
"country_code": "US",
"telephone_number": "734-495-1722",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "308 Barnes Rd",
"address_purpose": "LOCATION",
"city": "Williamstown",
"state": "KY",
"postal_code": "410979483",
"country_code": "US",
"telephone_number": "859-331-3292",
"fax_number": "859-578-2864",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTS",
"first_name": "CHRISTOPHER",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-24",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "LPCCCA00211319",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401015235",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6401015235",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "610661458",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.