Active NPI
Keisha Roldan, MSW
- Clinical Social Worker
- Yahucoa, PR
National Provider Identifier
1194028415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9241
- Practice address
- Carretera 905 KM 2.2
Barrio Tejas
Yahucoa, PR 00767-0000 - Phone
- (787) 374-2253
- NPI assigned
- Dec 8, 2010
- Last updated
- Dec 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 9241 | PR | Primary |
Addresses
Primary practice location
Carretera 905 KM 2.2
Barrio Tejas
Yahucoa, PR 00767-0000
Mailing address
PO Box 917
San Lorenzo, PR 00754-0917
Phone (787) 374-2253
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 |
|---|---|---|---|
| 9241 | PR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291766400000",
"number": "1194028415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917",
"city": "SAN LORENZO",
"state": "PR",
"postal_code": "007540917",
"telephone_number": "787-374-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARRETERA 905 KM 2.2",
"address_2": "BARRIO TEJAS",
"city": "YAHUCOA",
"state": "PR",
"postal_code": "007670000",
"telephone_number": "787-374-2253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLDAN",
"first_name": "KEISHA",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-08",
"last_updated": "2010-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PR",
"license": "9241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.