Roberson, Mary Kathleen
Roberson, Mary Kathleen is an sole proprietor health care provider with primary practice located at 665 Emory Valley Rd Ste. A, Oak Ridge TN 37830-7762. She recently has 9 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Clinical, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Health Service. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Roberson, Mary Kathleen can be contacted via phone (865) 482-0981.Contact Information
Primary practice address
665 Emory Valley Rd Ste. A
Oak Ridge TN 37830-7762
Phone: (865) 482-0981
Fax: (865) 482-0959
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | P-1349 | Tennessee |
| Behavioral Health & Social Service Providers / Adult Development & Aging | 103TA0700X | P-1349 | Tennessee |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | P-1349 | Tennessee |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | 4367660 | Tennessee |
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | P-1349 | Tennessee |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | P-1349 | Tennessee |
| Behavioral Health & Social Service Providers / Family | 103TF0000X | P-1349 | Tennessee |
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | P-1349 | Tennessee |
| Behavioral Health & Social Service Providers / Health Service | 103TH0100X | P-1349 | Tennessee |
Profile Details
| NPI number | 1992775704 |
|---|---|
| LBN Legal business name | Roberson, Mary Kathleen |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992775704 | NPPES |
| Tennessee | MEDICAID | 3687063 |
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