Individual provider Active NPI

Jennifer Rodzvilla, LCSW

  • Clinical Social Worker
  • Doylestown, PA
National Provider Identifier
1376638593
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006315 Issued in VA
Practice address
833 E Butler Ave
Doylestown, PA 18901-2280
Phone
(215) 340-1500
Fax
(215) 489-3020
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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 0904006315 VA Primary

Addresses

Primary practice location

833 E Butler Ave
Doylestown, PA 18901-2280

Mailing address

150 Oakland Ave
Apt. A306
Lansdale, PA 19446-3257
Phone (804) 239-9100

Other identifiers 1

IdentifierTypeStateIssuer
004945182MedicaidVA

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
0904006315VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1376638593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 OAKLAND AVE",
            "address_2": "APT. A306",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194463257",
            "telephone_number": "804-239-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 E BUTLER AVE",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012280",
            "telephone_number": "215-340-1500",
            "fax_number": "215-489-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODZVILLA",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945182",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; 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.