Individual provider Active NPI

Emily Roll, MSSA, LISW-S

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1538489091
Registry record updated Jun 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0900109-SUPV Issued in OH
Practice address
3500 Lorain Ave Ste 407
Cleveland, OH 44113-3726
Phone
(216) 200-8543
Fax
(216) 744-1114
NPI assigned
Jun 8, 2010
Last updated
Jun 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2024

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 I.0900109-SUPV OH Primary

Addresses

Primary practice location

3500 Lorain Ave Ste 407
Cleveland, OH 44113-3726

Mailing address

14618 Rainbow Ave
Cleveland, OH 44111-2221
Phone (440) 263-1279

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0900109-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Roll Lisw-S LLC Clinical CurrentSince Jun 30, 2024 Accepting new patients

Locations

3500 Lorain Ave
Ste 407
Cleveland, OH 44113
Phone (216) 200-8543

Organizations & group practices 1

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": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719619200000",
    "number": "1538489091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14618 RAINBOW AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441112221",
            "telephone_number": "440-263-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 LORAIN AVE STE 407",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133726",
            "telephone_number": "216-200-8543",
            "fax_number": "216-744-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLL",
        "first_name": "EMILY",
        "credential": "MSSA, LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2024-06-29",
        "certification_date": "2024-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0900109-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.