Katelyn Rola, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096899 Issued in NY

Practice address

214 West St
Warwick, NY 10990-3214

Phone

(551) 497-0433

NPI assigned

Jan 30, 2024

Last updated

Mar 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 6, 2024 through Feb 6, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Jessica C. Sullivan LCSW, PLLC

  dba Nourish Your Mind Counseling & Psychotherapy

  • Clinical Social Worker
  • Monroe, NY
  • NPI 1811532385
  NPD (past)

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1114789534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "SUGAR LOAF",
            "state": "NY",
            "postal_code": "109810097",
            "telephone_number": "551-497-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 WEST ST",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109903214",
            "telephone_number": "551-497-0433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Deer Trail Road",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "NY",
            "postal_code": "10918",
            "country_code": "US",
            "telephone_number": "551-497-0433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLA",
        "first_name": "KATELYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Rivera, PHARMD
• Anthony Edward Rizzotti, PTA
• Joelle Rodriguez, O.D.
• Heather Roecker, RN
• Jonathon Roerden, ATC, LAT
• Roman & Sturman, Inc. (Warwick Valley Psychological Center)
• Joseph Roman, PH.D.
• Sylvia Roome
• Stewart Yves Ross, PT
• Patricia Ann Rossi, M.D.

• Clinical Social Worker in Warwick, NY
• Providers in Warwick, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.