Michael Dean Roberts, PH.D.
Individual provider Active NPI Clinical Psychologist · Oxford, MS
NPI 1962597708 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962597708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 15-174 (MS)
- Practice address
- 152 Highway 7 S
Oxford, MS 38655-5392 - Phone
- (662) 234-7521
- Fax
- (662) 346-3071
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northeast Mental Health-Mental Retardation Commission
Practice addresses (Care Compare)
499 Gloster Creek VLG
Tupelo, MS 38801-4600
Phone (662) 844-1717
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130617000147 | MS | Practitioner - Clinical Psychologist | 9234378670 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Mental Health/Mental Retardation Commission | Current | Accepting new patients | |
| Northeast Mental Health-Mental Retardation Commission | Current |
Accepting new patients | |
| Northeast Mental Health-Mental Retardation Commission | Current |
Accepting new patients |
Locations
2434 S Eason Blvd
Tupelo, MS 38804
Phone (662) 640-4595
499 Gloster Creek Vlg
Ste A3
Tupelo, MS 38801
Phone (662) 640-4595
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 15-174 | MS | Yes |
Addresses
Primary practice location
152 Highway 7 S
Oxford, MS 38655-5392
Mailing address
152 Highway 7 South
Oxford, MS 38655-5392
Phone (662) 234-7521
Other providers in Oxford, MS
- Cason Benton Robbins
- Ashley Savannah Roberson
- Robert F. Cooper III MD PA
- Laqwaqnda Roberts-Buckley
- Gloria Jean Roberts
- Alice Pearl Robinson
- Curtis Scott Robinson
- Kimberly Shirell Robinson
- Megan Robinson
- Erin Robison
All providers in Oxford, MS · Clinical Psychologist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.