Active NPI
Marjorie Ruth Roccoberton, MARJORIE ROCCOBERTON
- Mental Health Counselor
- Bolton, CT
National Provider Identifier
1881974855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 000292
- Practice address
- 82 Shoddy Mill Rd
Bolton, CT 06043-7818 - Phone
- (860) 977-0630
- NPI assigned
- Aug 23, 2011
- Last updated
- Apr 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 000292 | CT | Primary |
| Professional Counselor | 101YP2500X | 000292 | CT | |
| School Counselor | 101YS0200X | 2102085697 | CT | |
| Marriage & Family Therapist | 106H00000X | 000292 | CT |
Addresses
Primary practice location
82 Shoddy Mill Rd
Bolton, CT 06043-7818
Mailing address
82 Shoddy Mill Rd.
Bolton, CT 06043-7818
Phone (860) 977-0630
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000292 | Other | CT | LICENSED PROFESSIONAL COUNSELOR |
| 2102085697 | Other | CT | CERTIFIED SCHOOL COUNSELOR |
Other names 1
- Marjorie Ruth Roccoberton
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 |
|---|---|---|---|
| 000292 | CT | MD | Mental Health Counselor |
| 2102085697 | CT | MD | School Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396915200000",
"number": "1881974855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 SHODDY MILL RD.",
"city": "BOLTON",
"state": "CT",
"postal_code": "060437818",
"telephone_number": "860-977-0630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "82 SHODDY MILL RD",
"city": "BOLTON",
"state": "CT",
"postal_code": "060437818",
"telephone_number": "860-977-0630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCCOBERTON",
"first_name": "MARJORIE",
"middle_name": "RUTH",
"credential": "MARJORIE ROCCOBERTON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-23",
"last_updated": "2014-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": "000292",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "000292",
"primary": false
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "CT",
"license": "2102085697",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "000292",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED PROFESSIONAL COUNSELOR",
"identifier": "000292",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED SCHOOL COUNSELOR",
"identifier": "2102085697",
"state": "CT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARJORIE",
"last_name": "ROCCOBERTON",
"middle_name": "RUTH",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bolton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.