Rosie Benzonelli, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60815525 Issued in WA

Practice address

850 Shady Oak Dr
Santa Rosa, CA 95404-2780

Phone

(919) 923-7673

NPI assigned

Oct 21, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2022 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1540080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1598231235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8290 165TH AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523948",
            "telephone_number": "425-869-2644",
            "fax_number": "425-867-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 SHADY OAK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954042780",
            "telephone_number": "919-923-7673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENZONELLI",
        "first_name": "ROSIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-21",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60815525",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "78474",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LCSW LICENSE",
            "identifier": "78474",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Soheila Benrazavi, MD
• McKayla Bensley, CADC
• Laurel Diane Benson, LMFT
• Melissa Elizabeth Bentley
• Jo Woodruff Benwell
• Michelle Bercut
• Jelena Berena, MD
• Roberta L Berg, MD
• Stephen Scott Berger, DDS
• Sharon Bergeron, LMFT

• Clinical Social Worker in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.