Brenda Jean Roberts, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW11659 Issued in FL

Practice address

3238 S Lecanto Hwy
Lecanto, FL 34461-9025

Phone

(352) 628-5020

Fax

(352) 628-2016

NPI assigned

Oct 24, 2013

Last updated

Nov 1, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Brenda Jean Allen Former 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifestream Behavioral Center Inc

  • Primary Care Clinic/Center
  • Leesburg, FL
  • NPI 1659613776
  NPD (past)

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1881022135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5664 SW 69TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344745677",
            "telephone_number": "352-291-5485",
            "fax_number": "352-291-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3238 S LECANTO HWY",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344619025",
            "telephone_number": "352-628-5020",
            "fax_number": "352-628-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRENDA",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11659",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW6803",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "ALLEN",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lawrence Wiliam Reidt, LMFT
• Restore Therapy Services of Florida LLC (Restore Therapy Services of Florida Lecanto)
• Gliset Restrepo, PA-C
• Ronald Christopher Reudink, PA
• Chad Ridge
• Shayla Robinson, COTA/L
• Arminda Rodriguez, LCSW
• Tammy Rogers, COTA
• Sunil Rohatgi, MD
• Rosecastle of Lecanto, LLC (Rosecastle of Citrus)

• Clinical Social Worker in Lecanto, FL
• Providers in Lecanto, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.