Individual provider Active NPI

Chelcy Rolph

  • Clinical Social Worker
  • Jefferson City, TN
National Provider Identifier
1255041620
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
222 E Broadway Blvd Ste 205
Jefferson City, TN 37760-2837
Phone
(865) 999-0601
NPI assigned
Nov 28, 2022
Last updated
Nov 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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 Primary

Addresses

Primary practice location

222 E Broadway Blvd Ste 205
Jefferson City, TN 37760-2837

Mailing address

222 E Broadway Blvd Ste 205
Jefferson City, TN 37760-2837
Phone (865) 999-0601

Other identifiers 1

IdentifierTypeStateIssuer
150404291OtherTNDRIVERS LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ClinicSource

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20260501000805 TN Practitioner - Clinical Social Worker 7911475504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

317 18TH Ave N
Suite 200
Nashville, TN 37203-2253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Behavioral Health Solutions, LLC Clinical CurrentSince Jan 12, 2025 Accepting new patients

Locations

222 E Broadway Blvd
Ste 205
Jefferson City, TN 37760
Phone (865) 991-0601

317 18th Ave N
Ste 200
Nashville, TN 37203
Phone (615) 292-3661

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1255041620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E BROADWAY BLVD STE 205",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602837",
            "telephone_number": "865-999-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E BROADWAY BLVD STE 205",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602837",
            "telephone_number": "865-999-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLPH",
        "first_name": "CHELCY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "150404291",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ClinicSource",
            "affiliation": "N",
            "endpointDescription": "Cloud-based EHR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ClinicSource",
            "address_1": "222 E Broadway Blvd Ste 205",
            "city": "Jefferson City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377602837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

Verify at the official NPI Registry.