Individual provider Active NPI

Jill Susan Rosenberg, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1497306898
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
8831 Venice Blvd
Los Angeles, CA 90034-3223
Phone
(310) 204-5200
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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 Primary

Addresses

Primary practice location

8831 Venice Blvd
Los Angeles, CA 90034-3223

Mailing address

12223 Dunoon LN
Los Angeles, CA 90049-4001
Phone (310) 617-6286

Other practice location 1

12223 Dunoon Ln
Los Angeles, CA 90049-4001
Phone (310) 617-6286

Other names 1

  • Jill Leevan Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1497306898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12223 DUNOON LN",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900494001",
            "telephone_number": "310-617-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8831 VENICE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343223",
            "telephone_number": "310-204-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12223 Dunoon Ln",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900494001",
            "country_code": "US",
            "telephone_number": "310-617-6286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "JILL",
        "middle_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "LEEVAN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.