Jeremy Rossa Cole, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

19045 State Highway 305 NE Ste 205
Poulsbo, WA 98370

Phone

(360) 930-0615

Fax

(360) 598-3235

NPI assigned

Feb 5, 2007

Last updated

Jul 27, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1962541151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18511 HARRIS AVE NE",
            "city": "SUQUAMISH",
            "state": "WA",
            "postal_code": "983929697",
            "telephone_number": "207-797-3434",
            "fax_number": "360-930-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19045 STATE HIGHWAY 305 NE STE 205",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "98370",
            "telephone_number": "360-930-0615",
            "fax_number": "360-598-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "JEREMY",
        "middle_name": "ROSSA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7194211",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "034373",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chymiymattymd LLC (Pacifica Medicine and Wellness)
• CJM Consulting LLC
• Chase Nathanial Clark, D.C.
• Jonna Clark, MS, OTR/L
• Alicia McKenna Cole, P.T.
• Ann Michelle Collins
• Judith Glass Collins, PHD
• Lacey M Collins, LMP
• Margaret Colson, NP
• Alexander Nathaniel Combs-Bachmann, DO

• Clinical Social Worker in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.