Individual provider Active NPI

Roza Cathrina Bockelman, LICSW, CDP

  • Clinical Social Worker
  • Puyallup, WA
National Provider Identifier
1013074954
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60127918 Issued in WA
Practice address
325 E Pioneer
Puyallup, WA 98372-3265
Phone
(253) 697-8400
Fax
(253) 697-8590
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60106906 WA
Social Worker 104100000X LW60127918 WA
Clinical Social Worker 1041C0700X LW60127918 WA Primary

Addresses

Primary practice location

325 E Pioneer
Puyallup, WA 98372-3265

Mailing address

325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 697-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100629000145 WA Practitioner - Clinical Social Worker 1850422213 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valera Medical PCGroup PAC ID 0547690521, 160 clinicians

Practice addresses (Care Compare)

1455 NW Leary Way
Suite 400
Seattle, WA 98107-5138
Phone (646) 450-7748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP60106906WAMDAddiction (Substance Use Disorder) Counselor
LW60127918WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 18, 2014 Accepting new patients
Sound CurrentSince May 3, 2010 Accepting new patients
Multicare Health System Addiction (Substance Use Disorder) CurrentSince Oct 18, 2014 Accepting new patients
Multicare Health System Current Accepting new patients

Locations

4238 Auburn Way N
Auburn, WA 98002
Phone (253) 444-0106

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

325 E Pioneer
Puyallup, WA 98372
Phone (253) 445-8120

1600 E Olive St
Seattle, WA 98122
Phone (206) 302-2800

6400 Southcenter Blvd
Tukwila, WA 98188
Phone (206) 444-3600

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1013074954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E PIONEER",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723265",
            "telephone_number": "253-697-8400",
            "fax_number": "253-697-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E PIONEER",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723265",
            "telephone_number": "253-697-8400",
            "fax_number": "253-697-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCKELMAN",
        "first_name": "ROZA",
        "middle_name": "CATHRINA",
        "name_prefix": "Miss",
        "credential": "LICSW, CDP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60106906",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW60127918",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60127918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.