Individual provider Active NPI

Victoria Anne Roybal, LCSW

  • Clinical Social Worker
  • Nashville, TN
National Provider Identifier
1730731621
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1921 Ransom PL
Nashville, TN 37217-3841
Phone
(888) 291-4357
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M-11097 NM
Clinical Social Worker 1041C0700X SWB-2022-0986 NM
Clinical Social Worker 1041C0700X Primary
Clinical Social Worker 1041C0700X M-11097 NM

Addresses

Primary practice location

1921 Ransom PL
Nashville, TN 37217-3841

Mailing address

1921 Ransom PL
Nashville, TN 37217-3841
Phone (888) 291-4357

Other names 1

  • Victoria Anne Outlaw Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212003295 TN Practitioner - Clinical Social Worker 9739559964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
M-11097NMMDSocial Worker
SWB-2022-0986NMMDClinical Social Worker
9005TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Tennessee, Inc. CurrentSince Jan 3, 2024 Accepting new patients
Centerstone of Tennessee, Inc. CurrentSince Jan 3, 2024 Accepting new patients

Locations

2400 White Ave
Nashville, TN 37204
Phone (615) 460-4200

1921 Ransom Pl
Nashville, TN 37217
Phone (615) 279-6700

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1730731621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 RANSOM PL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372173841",
            "telephone_number": "888-291-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 RANSOM PL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372173841",
            "telephone_number": "888-291-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYBAL",
        "first_name": "VICTORIA",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-11097",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2022-0986",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "M-11097",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "OUTLAW",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.