Individual provider Active NPI

Rochelle Marie Hall, LCSW

  • Clinical Social Worker
  • Kissimmee, FL
National Provider Identifier
1770804783
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10492 Issued in FL
Practice address
3501 W Vine St Ste 511
Kissimmee, FL 34741-4601
Phone
(407) 744-3554
NPI assigned
Jun 14, 2010
Last updated
Oct 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW10492 FL
Clinical Social Worker 1041C0700X ISW5395 FL
Clinical Social Worker 1041C0700X SW10492 FL Primary

Addresses

Primary practice location

3501 W Vine St Ste 511
Kissimmee, FL 34741-4601

Mailing address

3501 W Vine St Ste 511
Kissimmee, FL 34741-4601
Phone (407) 744-3554

Other identifiers 1

IdentifierTypeStateIssuer
004165100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230827000023 MD Practitioner - Clinical Social Worker 8729254388 Reassigns benefits to 2 organizations
I20240508004101 DC Practitioner - Clinical Social Worker 8729254388 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW5395FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Counseling Christian Ministry, LLC CurrentSince Jul 17, 2023 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Apr 16, 2024 Accepting new patients
Restorative Behavioral Health, Inc. Social Worker CurrentSince Mar 13, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

314 Franklin Ave
Ste 403
Berlin, MD 21811
Phone (410) 629-1995

9956 N Main St
Unit 4
Berlin, MD 21811
Phone (410) 629-1845

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1770804783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 W VINE ST STE 511",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414601",
            "telephone_number": "407-744-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 W VINE ST STE 511",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414601",
            "telephone_number": "407-744-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ROCHELLE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW10492",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW5395",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004165100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.