Roxanne Halczak, LCSW/MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20799 Issued in CA

Practice address

1711 3Rd St
Eureka, CA 95501-0714

Phone

(707) 268-2800

Fax

(707) 445-7547

NPI assigned

Jun 9, 2005

Last updated

Oct 19, 2010By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Humboldt

  dba Humboldt County Behavioral Health

  • Community/Behavioral Health Agency
  • Eureka, CA
  • NPI 1033300306
  NPD
• County of Humboldt

  • Clinical Medical Laboratory
  • Eureka, CA
  • NPI 1689751687
  NPD
• County of Humboldt

  • State or Local Public Health Clinic/Center
  • Eureka, CA
  • NPI 1871676213
  NPD
• Humboldt County Behavioral Health

  dba Children's Behavioral Health Clinic

  • Community/Behavioral Health Agency
  • Eureka, CA
  • NPI 1164576922
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1396749230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 3RD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010714",
            "telephone_number": "707-268-2800",
            "fax_number": "707-445-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 3RD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010714",
            "telephone_number": "707-268-2800",
            "fax_number": "707-445-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALCZAK",
        "first_name": "ROXANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW/MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "LCS 20799",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "20799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Hackworth, DC
• Kim Hagans
• Christian Hagge, DDS, MS
• Sally Haiken
• Erica Haines
• Forrest Hale
• Trevor Hale
• Shirley Lorraine Hall Moulton, PHN RN MPHA
• Casey Ilene Hall, RN
• Eric Hall

• Clinical Social Worker in Eureka, CA
• Providers in Eureka, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.