Nicole Lea Roberts, LMFT, LCPC, PMH-C

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

BBH-LCPC-LIC-29694 Issued in MT

Practice address

4273 44TH Ave S
Fargo, ND 58104-3939

Phone

(701) 526-4885

NPI assigned

Feb 6, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1790223162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4273 44TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581043939",
            "telephone_number": "701-526-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4273 44TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581043939",
            "telephone_number": "701-526-4885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Sunnyview Ln Ste 101",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013128",
            "country_code": "US",
            "telephone_number": "406-751-8009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "NICOLE",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "LMFT, LCPC, PMH-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-06",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ND",
            "license": "2015-051",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3473",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-LCPC-LIC-29694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "210 Sunnyview Lane",
            "address_2": "Suite 101",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Whitney Marie Sundheim Robers, DC
• Robert a. Bond, D.D.S.
• Robert J. Schulte, Jr. PA
• Amanda Leigh Roberts
• Carrie M Roberts, APRN,CNP
• Promise K Roberts
• Valerie Ann Roberts, RN
• Aaron Roy Robertson, M.D.
• Maronda Robertson, LPC
• Joseph R Robillard, LCSW

• Mental Health Counselor in Fargo, ND
• Providers in Fargo, ND by specialty
• Mental Health Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.