Individual provider Active NPI

Hannah Elizabeth Roble, LCSW

  • Clinical Social Worker
  • Fayetteville, AR
National Provider Identifier
1811251770
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10216-C Issued in AR
Practice address
2013 N Green Acres Rd Ste C
Fayetteville, AR 72703-2600
Phone
(479) 477-2352
NPI assigned
Jun 26, 2012
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X 10216-C AR Primary

Addresses

Primary practice location

2013 N Green Acres Rd Ste C
Fayetteville, AR 72703-2600

Mailing address

2013 N Green Acres Rd Ste C
Fayetteville, AR 72703-2600
Phone (479) 477-2352

Other practice location 1

20302 Colonel Glenn Rd
Little Rock, AR 72210-5347
Phone (501) 821-2145

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

State licenses

LicenseStateTypeSpecialty
10216-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Soul Purpose, LLC Clinical CurrentSince Aug 27, 2023 Accepting new patients

Locations

2013 N Green Acres Rd
Ste C
Fayetteville, AR 72703
Phone (479) 477-2352

Organizations & group practices 1

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1811251770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 N GREEN ACRES RD STE C",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032600",
            "telephone_number": "479-477-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 N GREEN ACRES RD STE C",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032600",
            "telephone_number": "479-477-2352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20302 Colonel Glenn Rd",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722105347",
            "country_code": "US",
            "telephone_number": "501-821-2145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBLE",
        "first_name": "HANNAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "10216-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.