Ida Roldan, PH.D., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

137 N Oak Park Ave
Suite 327
Oak Park, IL 60301-1344

Phone

(708) 660-9650

NPI assigned

Dec 29, 2006

Sex

Female

Sole proprietor

Yes

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Depth Counseling Services P C

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1033632104
  Medicare reassignment

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740346089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE",
            "address_2": "SUITE 327",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011344",
            "telephone_number": "708-660-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE",
            "address_2": "SUITE 327",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011344",
            "telephone_number": "708-660-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLDAN",
        "first_name": "IDA",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camiesa Rashida Rogers
• Janet Rogers, LMT/CMTPT
• Brian Scott Rohloff
• Tatiana Rohner
• Samantha Rojas
• Krysten Rollins, FNP-BC
• Sophia Alexandra Roman
• Cari Romany
• Wilfredo Jose Romero Ubillus, M.D.
• Eliza Isabel Romero, RBT

• Clinical Social Worker in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.