Kelly Jo Rolland, LCSW
Social Worker, Clinical in Longview, TX. Individual provider (NPI-1).
NPI number1336749563
StatusActive
Last updated in NPPESOct 27, 2020
Details
- NPI
- 1336749563
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kelly Jo Rolland
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 27, 2020
- Certification date
- Oct 27, 2020
- Last updated
- Oct 27, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 60856 | TX | Yes |
Practice location
2904 4th St Ste 102Longview, TX 75605-5124
Phone 903-806-2738
Mailing address
504 Cynthia DrLongview, TX 75605-3742
Phone 903-806-2738
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