Individual provider Active NPI

Tess Emily Rose, LCSW

  • Clinical Social Worker
  • Thornton, CO
National Provider Identifier
1306465752
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09927212 Issued in CO
Practice address
11271 Dexter Cir
Thornton, CO 80233
Phone
(720) 853-0800
NPI assigned
Apr 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 66842 TX
Clinical Social Worker 1041C0700X CSW.09927212 CO Primary
Social Worker 104100000X 66842 TX

Addresses

Primary practice location

11271 Dexter Cir
Thornton, CO 80233

Mailing address

11271 Dexter Cir
Thornton, CO 80233-2739
Phone (720) 853-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210224002438 TX Practitioner - Clinical Social Worker 5496160434 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09927212COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Travis County Mental Health and Mental Retardation Center CurrentSince Feb 9, 2021 Accepting new patients
Austin Travis County Mental Health and Mental Retardation Center Social Worker CurrentSince Feb 9, 2021 Accepting new patients

Locations

1165 Airport Blvd
Austin, TX 78702
Phone (512) 703-1312

1430 Collier St
Austin, TX 78704
Phone (512) 427-4357

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": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1306465752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11271 DEXTER CIR",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802332739",
            "telephone_number": "720-853-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11271 DEXTER CIR",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "80233",
            "telephone_number": "720-853-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "TESS",
        "middle_name": "EMILY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66842",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09927212",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "66842",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.