Jeffery James Roskelley, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW6019181 Issued in WA

Practice address

1200 Harris Avenue, Suite 410
Bellingham, WA 98225

Phone

(360) 340-9288

NPI assigned

Mar 1, 2011

Last updated

Dec 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 7, 2025 through Jan 7, 2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sound Life Recovery, PLLC

  • Community/Behavioral Health Agency
  • Bellingham, WA
  • NPI 1922780527
  NPD

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1558669564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HARRIS AVENUE, SUITE 410",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98225",
            "telephone_number": "360-340-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HARRIS AVENUE, SUITE 410",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98225",
            "telephone_number": "360-340-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSKELLEY",
        "first_name": "JEFFERY",
        "middle_name": "JAMES",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-01",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW6019181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley L Rosen, LMT
• Charlie J Rosenberg, RBT
• Rosewood Villa Opco LLC
• Alexander Rosinski, MD
• Chris Rosinski, DDS
• Jennifer L. Rosquist, M.D.
• Ariella K Ross, LMP
• Elizabeth Katrina Ross, MD
• Jamie Marie Ross, MS
• Jessica Ann Ross, PA-C, ATC

• Clinical Social Worker in Bellingham, WA
• Providers in Bellingham, 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 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.