Individual provider Active NPI

Heidi Roselle, LPCC

  • Mental Health Counselor
  • Los Alamitos, CA
National Provider Identifier
1780133850
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPCC9161 Issued in CA
Practice address
4012 Katella Ave Ste 105
Los Alamitos, CA 90720-3452
Phone
(562) 584-7799
NPI assigned
Sep 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PCCI2336 CA
Mental Health Counselor 101YM0800X LPCC9161 CA Primary

Addresses

Primary practice location

4012 Katella Ave Ste 105
Los Alamitos, CA 90720-3452

Mailing address

PO Box 8083
Long Beach, CA 90808-0083
Phone (562) 584-7799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 18, 2024 through Jan 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPCC9161CAMDMental Health Counselor
PCCI2336CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Onward Healing Counseling & Wellness, Inc. Mental Health CurrentSince Jan 31, 2021 Accepting new patients

Locations

4012 Katella Ave
Ste 105
Los Alamitos, CA 90720
Phone (562) 584-7799

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1780133850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8083",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908080083",
            "telephone_number": "562-584-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 KATELLA AVE STE 105",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203452",
            "telephone_number": "562-584-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSELLE",
        "first_name": "HEIDI",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PCCI2336",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC9161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.