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Individual
MS. STACEY ANN ROTH
Active
Individual
MS. STACEY ANN ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2005028635
MO
101YP2500X
Professional Counselor
Primary
2005028635
MO
171M00000X
Case Manager/Care Coordinator
2005028635
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497513705
—
MO
Enumeration date
01/06/2006
Last updated
06/05/2023
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