Individual provider Active NPI

Heather McLaren Roselaren, LCSW/MPH

  • Clinical Social Worker
  • Berkeley, CA
National Provider Identifier
1184662603
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS14038 Issued in CA
Practice address
1918 Bonita Ave Ste 200
Berkeley, CA 94704-1014
Phone
(510) 527-1217
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2021

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 LCS14038 CA Primary

Addresses

Primary practice location

1918 Bonita Ave Ste 200
Berkeley, CA 94704-1014

Mailing address

1918 Bonita Ave Ste 200
Berkeley, CA 94704-1014
Phone (510) 527-1217

Other identifiers 2

IdentifierTypeStateIssuer
152219OtherCAMANAGED HEALTH NETWORK
200152681OtherCABLUE CROSS PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250528003066 CA Practitioner - Clinical Social Worker 2365961794 Practice locations: Berkeley, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS14038CAMDClinical Social Worker
14038CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1184662603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 BONITA AVE STE 200",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041014",
            "telephone_number": "510-527-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 BONITA AVE STE 200",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041014",
            "telephone_number": "510-527-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSELAREN",
        "first_name": "HEATHER",
        "middle_name": "MCLAREN",
        "name_prefix": "Ms.",
        "credential": "LCSW/MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS14038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "152219",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "200152681",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.