Roberta Borden Ketchum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

00478 Issued in TX

Practice address

2425 Fountain View Dr
Suite 275
Houston, TX 77057-4823

Phone

(713) 780-4644

Fax

(713) 780-2600

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992888986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 FOUNTAIN VIEW DR",
            "address_2": "SUITE 275",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574823",
            "telephone_number": "713-780-4644",
            "fax_number": "713-780-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 FOUNTAIN VIEW DR",
            "address_2": "SUITE 275",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574823",
            "telephone_number": "713-780-4644",
            "fax_number": "713-780-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "ROBERTA",
        "middle_name": "BORDEN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "00478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keswood Home Health Services, LLC
• Ketamine Wellness Centers Houston
• Megan Suzanne Ketcham, M.D.
• Tonya Ketcham, O.D.
• Sonya Lawon Ketchens, MD
• Kete Health Center LLC
• Sachin Ketkar
• Kyle Kettle, FNP-C
• Annemarie Rose Kettler, RD
• Pamela Marie Deaver Ketwaroo, M.D.

• Clinical Social Worker in Houston, TX
• Providers in Houston, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.