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ANETRIS NICOLE ROBERTSON
NPI 1609684067
Counselor - Mental Health in Clinton, MS

Active since December 18, 2024PECOS EnrolledAccepts Medicare Assignment
704 RESERVE DR, CLINTON, MS 39056(601) 502-4970 Get Directions Write a Review

NPPES record last updated: December 18, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Anetris Nicole Robertson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANETRIS NICOLE ROBERTSON (NPI 1609684067) is an individual mental health provider in Clinton, Mississippi and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1609684067
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameANETRIS NICOLE ROBERTSON
Location Address704 RESERVE DRClinton, MS 39056-5994
Mailing Address704 Reserve DrClinton, MS 39056-5994 · (601) 502-4970
Phone(601) 502-4970
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateDecember 18, 2024
NPPES CertifiedDecember 18, 2024
✔ NPI 1609684067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
704 RESERVE DR, Clinton, MS 39056
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Anetris Nicole Robertson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335659721
PECOS Enrollment IDI20250605002466
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Anetris Robertson's NPI number?

The NPI number for Anetris Robertson is 1609684067. It was assigned to this individual provider in the NPPES registry on December 18, 2024.

Where is Anetris Robertson located?

Anetris Robertson practices at 704 Reserve Dr, Clinton, MS 39056. The listed phone number is (601) 502-4970.

What is Anetris Robertson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Anetris Robertson enrolled in Medicare?

Yes. Anetris Robertson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Anetris Robertson was last updated on December 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.