Miriam Brenda Rollhaus, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

086047 Issued in NY

Practice address

11655 Queens Blvd
Forest Hills, NY 11375-7025

Phone

(347) 688-2165

NPI assigned

Oct 21, 2015

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1518339266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11655 QUEENS BLVD STE 216",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11655 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757025",
            "telephone_number": "347-688-2165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 E 147th St",
            "address_2": "4th Floor",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104554158",
            "country_code": "US",
            "telephone_number": "646-393-9680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLLHAUS",
        "first_name": "MIRIAM",
        "middle_name": "BRENDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090755-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irena Roitgarts, LCSW-R
• Cristian Jovan Rojas Romero
• Corey Rojas
• Yousef Rokhsar, DDS
• Rolland Rogers DDS Estate
• Reuben Rolnick, M.D.
• Carolina Roman Alzate
• Belinda Roman, MSED
• Brenda Roman, LMSW
• Alexander Romanov, PT

• Clinical Social Worker in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.