Jan L Roberts, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

Q1-0001042 Issued in DE

Practice address

1115 Broadway FL 11
New York, NY 10010-3400

Phone

(917) 983-2700

NPI assigned

Aug 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jan Roberts-Rudzinski Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Center for Integrative Mental Health

  • Clinical Social Worker
  • New York, NY
  • NPI 1477294361
  NPD Authorized official

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1851607360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 HILLSIDE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104017",
            "telephone_number": "302-668-3208",
            "fax_number": "302-655-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BROADWAY FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100103400",
            "telephone_number": "917-983-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1521 Concord Pike Ste 204",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198033645",
            "country_code": "US",
            "telephone_number": "302-655-2627",
            "fax_number": "302-655-2613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JAN",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0001042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAN",
            "last_name": "ROBERTS-RUDZINSKI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daniel Roberts, MD
• Delores Maria Roberts, LPN
• Elaine C Roberts, CASAC-T
• Holly Harlayne Roberts, D.O.
• James Kirkland Roberts, M.D.
• Jan Schinkel Roberts, MS-CCC-SLP/TSHH
• Jasmine Roberts
• Jennifer Y Roberts, LCSW
• Jeremy Roberts, MD
• Joenine Elena Roberts, L.M.S.W., L.P.

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.