Active NPI
Elyse Rosen, LCSW
- Clinical Social Worker
- Temple, TX
National Provider Identifier
1093077414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 30183
- Practice address
- 3010 Scott Blvd
Suite 103
Temple, TX 76504 - Phone
- (254) 773-4022
- Fax
- (254) 773-0919
- NPI assigned
- Jun 12, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 30183 | TX | Primary |
Addresses
Primary practice location
3010 Scott Blvd
Suite 103
Temple, TX 76504
Mailing address
3010 Scott Blvd
Suite 103
Temple, TX 76504-6800
Phone (254) 773-4022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30183 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chupik Counseling & Consulting PA | Clinical | Past | Accepting new patients |
| Progressive Behavioral Health, PLLC | Clinical | Past | Accepting new patients |
Organizations & group practices 2
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": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1093077414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 SCOTT BLVD",
"address_2": "SUITE 103",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765046800",
"telephone_number": "254-773-4022",
"fax_number": "254-773-0919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 SCOTT BLVD",
"address_2": "SUITE 103",
"city": "TEMPLE",
"state": "TX",
"postal_code": "76504",
"telephone_number": "254-773-4022",
"fax_number": "254-773-0919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSEN",
"first_name": "ELYSE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-12",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "30183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.