Kathy L Roberts, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C2692 Issued in MS

Practice address

15012 Lemoyne Blvd
Biloxi, MS 39532-5205

Phone

(228) 396-8460

Fax

(228) 396-1141

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1902927809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 HOSPITAL ST",
            "address_2": "SUITE 104",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815312",
            "telephone_number": "228-696-9224",
            "fax_number": "228-696-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15012 LEMOYNE BLVD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395325205",
            "telephone_number": "228-396-8460",
            "fax_number": "228-396-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KATHY",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C2692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07703301",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE",
            "identifier": "C2692",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rise Psychotherapy and Family Support Services, PLLC
• Taylor Ritchey, MS, LPC, NCC
• Melissa Ladner Rivera, M.S., CCC-SLP
• Antoine Rizk, M.D.
• Kristy Rena Robbins
• Mark David Roberts, D.M.D.
• Kayla Robertson
• Shelia Robinett, PSYD
• Ryan Hugh Robinson
• Sametria Robinson

• Clinical Social Worker in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.

Verify at the official NPI Registry.