Heidi Elizabeth Ely Rothrock, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC61613809 Issued in WA

Practice address

5108 196TH St SW
Lynnwood, WA 98036-6152

Phone

(425) 582-2041

NPI assigned

Jan 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Heidi Elizabeth Ely Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Pacific Mental Health Oregon LLC

  • Counselor
  • Portland, OR
  • NPI 1811776933
  NPD

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1447011101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85082 WINESAP RD",
            "city": "MILTON FREEWATER",
            "state": "OR",
            "postal_code": "978627362",
            "telephone_number": "509-386-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 196TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366152",
            "telephone_number": "425-582-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHROCK",
        "first_name": "HEIDI",
        "middle_name": "ELIZABETH ELY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61613809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "ELY",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elijah Reuben Roque, LMP
• Christopher Michael Rosado, BCBA-D
• Jill Elaine Rosenthal, PSY.D.
• Katie S Roskilly, LMHCA
• Tiffany Roth, DPT
• Colleen Rottman, DPT
• Marina Gesine Roughton
• Cindy Jo Rowley, MSPA,CCC-SLP
• Brenda Roy
• Thomas Norman Royce Jr., RN

• Clinical Social Worker in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.