Individual provider Active NPI

Rolando Benitez Elizondo Jr., LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1245454800
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
39851 Issued in TX
Practice address
310 Sul Ross St
Houston, TX 77006-5116
Phone
(713) 364-6755
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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 39851 TX Primary

Addresses

Primary practice location

310 Sul Ross St
Houston, TX 77006-5116

Mailing address

310 Sul Ross St
Houston, TX 77006-5116
Phone (713) 364-6755

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

LicenseStateTypeSpecialty
39851TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rollie B. Elizondo Psychotherapy & Counseling PLLC CurrentSince May 1, 2020 Accepting new patients
Family Psychiatry of the Woodlands PA Past Accepting new patients

Locations

310 Sul Ross St
Houston, TX 77006
Phone (713) 730-9276

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18657/brand/1/csg/1/fhir/r4

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1245454800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 SUL ROSS ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770065116",
            "telephone_number": "713-364-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SUL ROSS ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770065116",
            "telephone_number": "713-364-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "ROLANDO",
        "middle_name": "BENITEZ",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "39851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.