Jennifer Beth Rose, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-06999 Issued in NM

Practice address

2111 Golf Course Rd SE Ste D
Rio Rancho, NM 87124-1634

Phone

(505) 639-1312

NPI assigned

Jun 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Walk the Walk Counseling LLC

  • Mental Health Counselor
  • Rio Rancho, NM
  • NPI 1598218190
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1104864255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 GOLF COURSE RD SE STE D",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241634",
            "telephone_number": "505-639-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 GOLF COURSE RD SE STE D",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241634",
            "telephone_number": "505-639-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JENNIFER",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-06999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02351714",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 2",
            "identifier": "1598218190",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE",
            "identifier": "1104864255",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17301866",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savannah Romero, OTR/L
• Stacey Grace Romero, LPCC
• Tammy Romero, PHARM D
• Tomas Teodoro Romero, LMHC
• Trinity Rosa
• Esther E Rosenberg, PHARMD, PHC
• Rosita'
• Suzanne Roth
• Lauren M Roverse, OD
• Anita M Roybal, MD

• Clinical Social Worker in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.