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KRISTY G ROBERTSON P-LPC
NPI 1811683501
Counselor in Vicksburg, MS

Active since April 14, 2023PECOS EnrolledAccepts Medicare Assignment
1414 CHERRY ST, VICKSBURG, MS 39180(601) 636-5703(769) 230-3039 Get Directions Write a Review

NPPES record last updated: April 14, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kristy G Robertson P-lpc NPPES

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

KRISTY G ROBERTSON P-LPC (NPI 1811683501) is an individual counselor in Vicksburg, Mississippi, licensed in Mississippi (P-0859) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1811683501
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameKRISTY G ROBERTSONCredential: P-LPC
Location Address1414 CHERRY STVicksburg, MS 39180-3218
Mailing Address1414 Cherry StVicksburg, MS 39180-3218 · (601) 636-5703 · Fax (769) 230-3039
Phone(601) 636-5703
Fax(769) 230-3039
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateApril 14, 2023
NPPES CertifiedApril 14, 2023
✔ NPI 1811683501 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in MS · P-0859
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
1414 CHERRY ST, Vicksburg, MS 39180
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kristy G Robertson P-lpc 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 ID8729507033
PECOS Enrollment IDI20250529001474
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.

Medicare Billing Reassignment

Medicare enrollment records show Kristy Robertson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Family Coaching Clinic
45 mi
Mental Health
105 EXECUTIVE DR STE B
Madison, MS 39110
  • Reassigned Medicare billing, Mississippi enrollment
  • 6 clinicians in this Medicare group
NPI 1730869892 (601) 506-2292

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. WALTER LEE FRAZIER MCP, LPC, NCC
Counselor (Professional)
1414 CHERRY ST
VICKSBURG, MS 39180
Warren County (601) 636-5703
HAROLD MELANCON LPC
Counselor (Professional)
1414 CHERRY ST
VICKSBURG, MS 39180
Warren County (601) 636-5703
TAMMANI TREVILLION LPC
Counselor (Professional)
1414 CHERRY ST
VICKSBURG, MS 39180
Warren County (601) 636-5703
JAYME SULLIVAN LPC
Counselor (Professional)
1414 CHERRY ST
VICKSBURG, MS 39180
Warren County (601) 636-5703
GRACE CHRISTIAN COUNSELING CENTER
Marriage & Family Therapist
1414 CHERRY ST
VICKSBURG, MS 39180
Warren County (601) 636-5703
MRS. CHANEY CARLUCCI LPC
Counselor (Professional)
1414 CHERRY ST
VICKSBURG, MS 39180
Warren County (601) 636-5703
STACI FLORIE WIGELSWORTH M.ED., NCC, P-LPC
Counselor
1414 CHERRY ST
VICKSBURG, MS 39180
Warren County (601) 636-5703
MS. SAMONIA LYNN ETHERIDGE LPC
Counselor (Professional)
1414 CHERRY ST
VICKSBURG, MS 39180
Warren County (601) 636-5703

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 Kristy Robertson's NPI number?

The NPI number for Kristy Robertson is 1811683501. It was assigned to this individual provider in the NPPES registry on April 14, 2023.

Where is Kristy Robertson located?

Kristy Robertson practices at 1414 Cherry St, Vicksburg, MS 39180. The listed phone number is (601) 636-5703.

What is Kristy Robertson's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Kristy Robertson enrolled in Medicare?

Yes. Kristy 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.

Which organization bills Medicare for Kristy Robertson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristy Robertson reassigns Medicare benefits to Family Coaching Clinic (Madison, MS). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kristy Robertson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kristy Robertson accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Kristy Robertson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kristy Robertson was last updated on April 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.