Individual Healthcare Provider
Kimberly Michelle Roberts, PSYD, LPC, CCM
Provider's NPPES record last updated: May 13, 2020
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1174697320
- Primary Specialty
- Counselor — Professional
- Practice Location
- Jacksonville, Oregon
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 1:20 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Counselor
Professional
Behavioral Health & Social Service Providers
Definition to come...
Taxonomy code 101YP2500X
Practice Locations
Practice Location
455 Hueners Ln
Jacksonville, Oregon 97530-9195
Phone: (615) 668-6775
Additional Practice Location
3354 Perimeter Hill Dr
Suite 320
Nashville, Tennessee 37211
Phone: (615) 331-3221
Fax: (615) 331-0378
Record Information
- Enumeration Date
- November 20, 2006
- Provider's NPPES Record Last Updated
- May 13, 2020
- Certification Date
- May 13, 2020
- NPISignal NPPES Dataset
- August 2026
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