Rochelle Nicole Kanallakan, CPSST

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

PE70097569 Issued in WA

Practice address

1400 Commerce Ave
Longview, WA 98632-3756

Phone

(360) 998-2047

Fax

(844) 612-6673

NPI assigned

May 6, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Rochelle Nicole Reiboldt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Core Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, WA
  • NPI 1639693781
  NPD (past)

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1366231201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2394",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328455",
            "telephone_number": "360-200-5419",
            "fax_number": "844-612-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 COMMERCE AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323756",
            "telephone_number": "360-998-2047",
            "fax_number": "844-612-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANALLAKAN",
        "first_name": "ROCHELLE",
        "middle_name": "NICOLE",
        "credential": "CPSST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-06",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG61557747",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "PE70097569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2327307",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROCHELLE",
            "last_name": "REIBOLDT",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaiser Foundation Health Plan of the Northwest
• Kaiser Permanente
• Kendra Hattie Kallemeyn, O.D.
• Taylor Alexandrea Kallio, RN
• Zeba Kamal, MD
• Heidi Lynnette Kangas, RN
• Mira R Kangas
• Emily H Kankelborg, AAC, CPC
• Roger John Karnofski, PT
• Karen Sachiko Kato, M.D.

• Peer Specialist in Longview, WA
• Providers in Longview, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; 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.