Individual provider Active NPI

Marie Elena Rosas, LCSW

  • Clinical Social Worker
  • Texas City, TX
National Provider Identifier
1558056424
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65255 Issued in TX
Practice address
3201 FM 2004 Rd
Texas City, TX 77591-2199
Phone
(832) 720-4768
Fax
(409) 986-6500
NPI assigned
Apr 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 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 65255 TX Primary

Addresses

Primary practice location

3201 FM 2004 Rd
Texas City, TX 77591-2199

Mailing address

4526 Backenberry Dr
Friendswood, TX 77546-8110
Phone (832) 629-0462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • 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
I20240919001332 TX Practitioner - Clinical Social Worker 4981145828 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Gulf Coast Center CurrentSince Sep 23, 2024 Accepting new patients
The Gulf Coast Center PastSince Sep 15, 2024 Accepting new patients

Locations

101 Tigner St
Angleton, TX 77515
Phone (800) 710-4322

4444 W Main St
League City, TX 77573
Phone (281) 640-0218

7510 FM 1765
Texas City, TX 77591
Phone (409) 935-6083

3201 FM 2004 Rd
Texas City, TX 77591
Phone (409) 944-4399

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": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1558056424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4526 BACKENBERRY DR",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775468110",
            "telephone_number": "832-629-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 FM 2004 RD",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775912199",
            "telephone_number": "832-720-4768",
            "fax_number": "409-986-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSAS",
        "first_name": "MARIE",
        "middle_name": "ELENA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texas City, TX

Sources for this page

Verify at the official NPI Registry.