Active NPI
Janet Roller, LICSW
- Clinical Social Worker
- Olympia, WA
National Provider Identifier
1639456288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW60167073
- Practice address
- 509 12TH Ave SE
Suite 20
Olympia, WA 98501-7514 - Phone
- (360) 556-2558
- NPI assigned
- Nov 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW60167073 | WA | Primary |
Addresses
Primary practice location
509 12TH Ave SE
Suite 20
Olympia, WA 98501-7514
Mailing address
509 12TH Ave SE
Suite 20
Olympia, WA 98501-7514
Phone (360) 556-2558
Other practice location 1
700 Lilly Rd NE
Olympia, WA 98506-5115
Phone (360) 923-7000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LW60167073 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623110400000",
"number": "1639456288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 12TH AVE SE",
"address_2": "SUITE 20",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985017514",
"telephone_number": "360-556-2558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 12TH AVE SE",
"address_2": "SUITE 20",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985017514",
"telephone_number": "360-556-2558"
}
],
"practiceLocations": [
{
"address_1": "700 Lilly Rd NE",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "985065115",
"country_code": "US",
"telephone_number": "360-923-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROLLER",
"first_name": "JANET",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-10",
"last_updated": "2021-06-08",
"certification_date": "2021-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60167073",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "700 Lilly Rd NE",
"city": "Olympia",
"state": "WA",
"country_code": "US",
"postal_code": "985065115",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.