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Individual
MR. DALE LEON ROTH
Active
Individual
MR. DALE LEON ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MDV DAVIS LMHP LAPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
562
NE
101YM0800X
Mental Health Counselor
2512
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85330
BCBS
—
01
—
97061
BCBS AUX
—
Enumeration date
10/06/2006
Last updated
09/11/2025
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