Individual provider Active NPI

Chriselda Luna Rodgers, B.S. QMHP

  • Clinical Social Worker
  • Conroe, TX
National Provider Identifier
1780047753
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100576 Issued in TX
Practice address
3412 Teas Nursery Rd
Conroe, TX 77304-4614
Phone
(281) 467-0636
Fax
(832) 747-7800
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 100576 TX Primary

Addresses

Primary practice location

3412 Teas Nursery Rd
Conroe, TX 77304-4614

Mailing address

3412 Teas Nursery Rd
Conroe, TX 77304-4614
Phone (281) 467-0636

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)
Not enrolled
Credentials
Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1780047753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 TEAS NURSERY RD",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044614",
            "telephone_number": "281-467-0636",
            "fax_number": "832-747-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 TEAS NURSERY RD",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044614",
            "telephone_number": "281-467-0636",
            "fax_number": "832-747-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "CHRISELDA",
        "middle_name": "LUNA",
        "name_prefix": "Mrs.",
        "credential": "B.S. QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "100576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.