Individual provider Active NPI

Reuben Rosen, LMSW

  • Clinical Social Worker
  • Kensington, MD
National Provider Identifier
1073110615
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26430 Issued in MD
Practice address
3930 Knowles Ave Ste 200
Kensington, MD 20895-2428
Phone
(240) 801-5843
NPI assigned
Oct 6, 2020
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 26430 MD Primary

Addresses

Primary practice location

3930 Knowles Ave Ste 200
Kensington, MD 20895-2428

Mailing address

11306 Monticello Ave
Silver Spring, MD 20902-3079
Phone (732) 896-4309

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address reuven@jgatherapy.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 22, 2024 through Jul 22, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26430MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1073110615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11306 MONTICELLO AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209023079",
            "telephone_number": "732-896-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 KNOWLES AVE STE 200",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952428",
            "telephone_number": "240-801-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "REUBEN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "26430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "reuven@jgatherapy.com",
            "affiliation": "N",
            "address_1": "3930 Knowles Ave Ste 200",
            "city": "Kensington",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208952428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kensington, MD

Sources for this page

Verify at the official NPI Registry.