Provider Demographics
NPI:1073575494
Name:ROBERTS, JAMES ARTHUR (MSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ARTHUR
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BUENA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:FAIRWAY
Mailing Address - State:KS
Mailing Address - Zip Code:66205-3229
Mailing Address - Country:US
Mailing Address - Phone:913-362-2119
Mailing Address - Fax:913-383-3181
Practice Address - Street 1:8826 SANTA FE DR
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-3672
Practice Address - Country:US
Practice Address - Phone:913-383-3333
Practice Address - Fax:913-383-3181
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0010111041C0700X
KS06841041C0700X
KS0150106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0002862Medicare ID - Type Unspecified
KS0493456107Medicare UPIN