DR. MARY KATHLEEN ROBERSON (NPI# 1992775704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992775704 |
| Entity Type | Individual |
| Full Name | DR. MARY KATHLEEN ROBERSON |
| Credential | PH.D. |
| Practice Address |
665 Emory Valley Rd Ste. A Oak Ridge TN 37830-7762 |
| Mailing Address |
Po Box 6408 Oak Ridge TN 37831-3733 |
| Practice Telephone | 8654820981 |
| Practice Fax Number | 8654820959 |
| Mailing Telephone | 8654820981 |
| Mailing Fax Number | 8654820959 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
P-1349 | TN | Behavioral Health & Social Service Providers |
| X | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
P-1349 | TN | Behavioral Health & Social Service Providers |
| X | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
P-1349 | TN | Behavioral Health & Social Service Providers |
| X | 103TC0700X |
Psychologist Specialization: Clinical |
P-1349 | TN | Behavioral Health & Social Service Providers |
| X | 103TC1900X |
Psychologist Specialization: Counseling |
P-1349 | TN | Behavioral Health & Social Service Providers |
| X | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
P-1349 | TN | Behavioral Health & Social Service Providers |
| X | 103TF0000X |
Psychologist Specialization: Family |
P-1349 | TN | Behavioral Health & Social Service Providers |
| X | 103TH0100X |
Psychologist Specialization: Health Service |
P-1349 | TN | Behavioral Health & Social Service Providers |
| X | 225700000X | Massage Therapist | 4367660 | TN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3687063 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902296502 | Mary Roberson | Counselor | 39385 N Stockton Ln, Beach Park, IL 60083-3010 | 2015-02-03 |
| 1013332006 | Mary Colleen Roberson | Registered Nurse | 272 Chamberlin Dr, Buffalo, NY 14210-2614 | 2014-02-27 |
| 1619500360 | Mary Elizabeth Roberson | Behavior Technician | 5121 Kingdom Way Ste 100, Raleigh, NC 27607-6063 | 2020-02-20 |
| Street Address |
665 EMORY VALLEY RD STE. A |
| City | OAK RIDGE |
| State | TN |
| Zip Code | 37830-7762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386889301 | Ailene Fay Radcliffe | Community Health Worker | 665 Emory Valley Rd, Ste. A, Oak Ridge, TN 37830-7762 | 2008-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194388702 | Oak Ridge Pharmacy | Pharmacy | 854 Main St W, Oak Ridge, TN 37830 | 2019-04-18 |
| 1134682693 | Mac's Pharmacy Oak Ridge, LLC | Pharmacy | 45 New York Avenue, Oak Ridge, TN 37830 | 2019-04-11 |
| 1689153876 | Tapuwa Martin Chikowore | Dentist | 377 S Illinois Ave, Oak Ridge, TN 37830 | 2018-08-09 |
| 1710475660 | Oak Ridge Smiles Dentistry, PC | Dentist | 377 S. Illinois Ave., Oak Ridge, TN 37830 | 2018-04-26 |
| 1417344763 | Heather Cupp | Social Worker | 723 Emory Valley Road, Oak Ridge, TN 37830 | 2015-04-23 |
| 1366701534 | Quality Care From The Heart | Preferred Provider Organization | 144 Newport Drive, Oak Ridge, TN 37830 | 2012-05-09 |
| 1578838223 | Second Chance Recovery In Faith, Inc | Community/Behavioral Health | 234 W Tennessee Ave, Oak Ridge, TN 37830 | 2012-03-14 |
| 1720364615 | Douglas Miller | Pharmacist | 1299 Oak Ridge Turnpike, Oak Ridge, TN 37830 | 2011-10-24 |
| 1619263852 | Namratha Reddy Vontela | Internal Medicine | 200 New York Ave Ste 200, Oak Ridge, TN 37830 | 2011-06-27 |
| 1356658165 | Fred Lewis Stephens | Social Worker | 150 E Division Rd Ste 10, Oak Ridge, TN 37830 | 2010-09-01 |
| Find all providers in zip 37830 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033629209 | Rebecca J Reed | Psychologist | 3003 Riverside Dr, Jackson, TN 38301-9160 | 2017-10-02 |
| 1255736153 | Sonya Glyn Moore | Psychologist | 400 W 1st North St Ste D, Morristown, TN 37814-4617 | 2014-11-04 |
| 1346493574 | Middle Tennessee Counseling Services, Inc | Psychologist | 435 Park Avenue, Stallings Building, Lebanon, TN 37087-3630 | 2008-10-31 |
| 1871658757 | Psychiatric Services of East Tennessee | Psychologist | 123 E Washington Ave, Athens, TN 37303 | 2006-12-22 |
| 1154774941 | Andrew Harper | Psychologist | 626 Bernard Ave, Knoxville, TN 37921-6253 | 2016-07-18 |
| 1548618416 | Journeypure Multyspecialty Group LLC | Psychologist | 5080 Florence Rd, Murfreesboro, TN 37129 | 2016-06-01 |
| 1114356219 | James Casey | Psychologist | 115 28th Ave N, Nashville, TN 37203-1411 | 2013-11-08 |
| 1386089605 | Recovery Physician Group of Tennessee, LLC | Psychologist | 101 Lea Ave, Nashville, TN 37210-2066 | 2013-04-30 |
| 1275799892 | Recovery Physician Group of Tennessee, LLC | Psychologist | 3175 Lenox Park Blvd Ste 412, Memphis, TN 38115-4256 | 2008-08-04 |
| 1952502445 | Mealer Psychological,pllc | Psychologist | 1037 Cresthaven Rd, Memphis, TN 38119-3833 | 2007-05-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.