Active NPI
Christopher James Roberts, LCSW, LCAS
- Clinical Social Worker
- Manteo, NC
National Provider Identifier
1902099476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C006108
- Practice address
- 704 N US Highway 64
Manteo, NC 27954-9009 - Phone
- (252) 216-9965
- NPI assigned
- Aug 19, 2007
- Last updated
- Jul 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1261 | NC | |
| Clinical Social Worker | 1041C0700X | C006108 | NC | Primary |
Addresses
Primary practice location
704 N US Highway 64
Manteo, NC 27954-9009
Mailing address
704 N US Highway 64
PO Box 161
Manteo, NC 27954-9009
Phone (252) 216-9965
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6112007 | Medicaid | NC |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C006108 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217203200000",
"number": "1902099476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 N US HIGHWAY 64",
"address_2": "PO BOX 161",
"city": "MANTEO",
"state": "NC",
"postal_code": "279549009",
"telephone_number": "252-216-9965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "704 N US HIGHWAY 64",
"city": "MANTEO",
"state": "NC",
"postal_code": "279549009",
"telephone_number": "252-216-9965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "CHRISTOPHER",
"middle_name": "JAMES",
"credential": "LCSW, LCAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-19",
"last_updated": "2008-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "1261",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C006108",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6112007",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manteo, NC
- Ocracoke Health Center, Inc. (Manteo Community Health Center Pharmacy)
- Outer Banks Dialysis Center LLC
- Outerbanks Professional Services LLC
- Jessica Phipps Owen, MS, LCMHC, LCAS
- Kevin Phillips, RPH
- Kelly F Roberts, LCSW
- Darana Louise Ruhle, ATC. LAT
- Troy Bunyon Sluder III, DDS
- Geary Daniel Smith, M.D.
- Ann C. Sumners, M. D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.