Individual provider Active NPI

Lisa Lynn Rolle, LCSW-C

  • Clinical Social Worker
  • Rockville, MD
National Provider Identifier
1407914971
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06925 Issued in MD
Practice address
15201 Shady Grove Rd
Suite 106
Rockville, MD 20850-3217
Phone
(301) 948-4395
Fax
(301) 840-8972
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 06925 MD Primary

Addresses

Primary practice location

15201 Shady Grove Rd
Suite 106
Rockville, MD 20850-3217

Mailing address

19038 Festival Dr
Boyds, MD 20841-4002
Phone (301) 515-5998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20111219000881 DC Practitioner - Clinical Social Worker 0648445718 Practice locations: Rockville, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15201 Shady Grove Rd
Rockville, MD 20850-3217
Phone (301) 948-4395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Physical Therapy Inc PastSince Mar 10, 1992 Accepting new patients
Primary Physical Therapy, Inc. PastSince May 1, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407914971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19038 FESTIVAL DR",
            "city": "BOYDS",
            "state": "MD",
            "postal_code": "208414002",
            "telephone_number": "301-515-5998",
            "fax_number": "301-840-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15201 SHADY GROVE RD",
            "address_2": "SUITE 106",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503217",
            "telephone_number": "301-948-4395",
            "fax_number": "301-840-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLE",
        "first_name": "LISA",
        "middle_name": "LYNN",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "06925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.