Active NPI
Malea Deven Roberson, LSW
- Social Worker
- Batavia, OH
National Provider Identifier
1831755503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1904395
- Practice address
- 1100 Hospital Dr
Batavia, OH 45103-1920 - Phone
- (513) 834-7063
- Fax
- (513) 873-1567
- NPI assigned
- May 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1904395 | OH | Primary |
Addresses
Primary practice location
1100 Hospital Dr
Batavia, OH 45103-1920
Mailing address
446 Morgan St
Cincinnati, OH 45206-2348
Phone (513) 834-7063
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0383779 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| S.1904395 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revivecincy LLC | Addiction (Substance Use Disorder) | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinical Social Worker
- Cincinnati, OH
- NPI 1073115028
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578355200000",
"number": "1831755503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "446 MORGAN ST",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452062348",
"telephone_number": "513-834-7063",
"fax_number": "513-873-1567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 HOSPITAL DR",
"city": "BATAVIA",
"state": "OH",
"postal_code": "451031920",
"telephone_number": "513-834-7063",
"fax_number": "513-873-1567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERSON",
"first_name": "MALEA",
"middle_name": "DEVEN",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-17",
"last_updated": "2020-01-07",
"certification_date": "2020-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1904395",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0383779",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Batavia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.