Individual provider Active NPI

Ciji Adlin Rosa, MSW, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1801614052
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105950 Issued in TX
Practice address
19500 TX Highway 249
Suite 120
Houston, TX 77070-2698
Phone
(844) 824-8775
Fax
(281) 648-2200
NPI assigned
Sep 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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 105950 TX Primary

Addresses

Primary practice location

19500 TX Highway 249
Suite 120
Houston, TX 77070-2698

Mailing address

19500 State Highway 249 Ste 120
Houston, TX 77070-3027
Phone (844) 824-8775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20241018003131 TX Practitioner - Clinical Social Worker 8123550811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

19500 St Hwy 249
Suite 120
Houston, TX 77070-3027
Phone (844) 824-8775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105950TXMDSpeech-Language Pathologist

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": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1801614052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 STATE HIGHWAY 249 STE 120",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770703027",
            "telephone_number": "844-824-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 TX HIGHWAY 249",
            "address_2": "SUITE 120",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770702698",
            "telephone_number": "844-824-8775",
            "fax_number": "281-648-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA",
        "first_name": "CIJI",
        "middle_name": "ADLIN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "105950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.