Kelly Jo Rolland, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60856 Issued in TX

Practice address

2904 4TH St Ste 102
Longview, TX 75605-5124

Phone

(903) 806-2738

NPI assigned

Oct 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1336749563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CYNTHIA DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756053742",
            "telephone_number": "903-806-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 4TH ST STE 102",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055124",
            "telephone_number": "903-806-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLAND",
        "first_name": "KELLY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarissa Rogers
• Jennifer Ann Rogers, D.D.S.
• Mattie Rogers, SPEECH THERAPIST
• Wendy Renee Rogers, APN
• Sondra G. Rolater, RN, FNP
• Marnie R Roozen, L.P.C.
• Curtis Roscoe
• Sohaila Y Roshan, MD
• David John Ross, LCSW
• John Bennett Ross V, D.D.S.

• Clinical Social Worker in Longview, TX
• Providers in Longview, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.