Active NPI
Kristine Marie Roberts, LCSW
- Clinical Social Worker
- Bastrop, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 67295
- Practice address
- 1106 College St Ste E
Bastrop, TX 78602-4021 - Phone
- (512) 521-3243
- NPI assigned
- Nov 20, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-16769 | AZ | |
| Clinical Social Worker | 1041C0700X | 149009815 | IL | |
| Clinical Social Worker | 1041C0700X | 67295 | TX | Primary |
Addresses
Primary practice location
1106 College St Ste E
Bastrop, TX 78602-4021
Mailing address
326 Belinda CT
Bastrop, TX 78602-6617
Phone (757) 879-2269
Other names 1
- Kris Marie Cisco
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1106 College St
Bastrop, TX 78602-4021
Phone (855) 284-7483
4903 82ND St
Suite 60
Lubbock, TX 79424-3123
Phone (855) 284-7483
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67295 | TX | MD | Professional Counselor |
| 149009815 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Current | Accepting new patients |
Locations
1000 Post and Paddock St
Ste 102
Grand Prairie, TX 75050
4903 82nd St
Ste 60
Lubbock, TX 79424
Phone (806) 507-6934
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553558400000",
"number": "1881875615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 BELINDA CT",
"city": "BASTROP",
"state": "TX",
"postal_code": "786026617",
"telephone_number": "757-879-2269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1106 COLLEGE ST STE E",
"city": "BASTROP",
"state": "TX",
"postal_code": "786024021",
"telephone_number": "512-521-3243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "KRISTINE",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-20",
"last_updated": "2019-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW-16769",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149009815",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "67295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRIS",
"last_name": "CISCO",
"middle_name": "MARIE",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Bastrop, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.