Active NPI
Jonathan Rosengren, MSW
- Counselor
- South Bend, IN
National Provider Identifier
1780053546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 33008049A
- Practice address
- 415 E Madison Street
South Bend, IN 46617-1109 - Phone
- (269) 815-5331
- NPI assigned
- Sep 22, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801098780 | MI | |
| Counselor | 101Y00000X | 33008049A | IN | Primary |
Addresses
Primary practice location
415 E Madison Street
South Bend, IN 46617-1109
Mailing address
300 W Ferry St
Berrien Springs, MI 49103-1109
Phone (269) 815-5331
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 |
|---|---|---|---|
| 33008049A | IN | MD | Counselor |
| 6801098780 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517875200000",
"number": "1780053546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W FERRY ST",
"city": "BERRIEN SPRINGS",
"state": "MI",
"postal_code": "491031109",
"telephone_number": "269-815-5331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 E MADISON STREET",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466171109",
"telephone_number": "269-815-5331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENGREN",
"first_name": "JONATHAN",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-22",
"last_updated": "2018-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801098780",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IN",
"license": "33008049A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.