Individual provider Active NPI

Kenneth L Roberts, LPCC,LCPC,LPC,LADC

  • Mental Health Counselor
  • Washington, DC
National Provider Identifier
1740503556
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC16525 Issued in MD
Practice address
2831 15TH St NW
Washington, DC 20009-4607
Phone
(202) 972-9873
NPI assigned
Mar 8, 2010
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1590 MN
Addiction (Substance Use Disorder) Counselor 101YA0400X 302801 MN
Mental Health Counselor 101YM0800X 200012606 DC
Mental Health Counselor 101YM0800X 0701014977 VA
Mental Health Counselor 101YM0800X E.2606573 OH
Mental Health Counselor 101YM0800X LC16525 MD Primary

Addresses

Primary practice location

2831 15TH St NW
Washington, DC 20009-4607

Mailing address

2831 15TH St NW
Washington, DC 20009-4607
Phone (202) 972-9873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20260504005657 DC Practitioner - Mental Health Counselor 9830633304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2831 15TH St NW
Suite 7
Washington, DC 20009-4607

9690 Martin Rd
Clarence Center, NY 14032-9792

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
302801MNMDAddiction (Substance Use Disorder) Counselor
200012606DCMDMental Health Counselor
LC16525MDMDMental Health Counselor
E.2606573OHMDMental Health Counselor
0701014977VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nuway Mental Health Clinic CurrentSince May 11, 2024 Accepting new patients

Locations

2217 Nicollet Ave
Minneapolis, MN 55404
Phone (612) 767-0309

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1740503556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 15TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200094607",
            "telephone_number": "202-972-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 15TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200094607",
            "telephone_number": "202-972-9873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KENNETH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "LPCC,LCPC,LPC,LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-08",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "1590",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302801",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "200012606",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701014977",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2606573",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC16525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.