Individual
ALEXANDRA ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8500 EXECUTIVE PARK AVE, SUITE 200, FAIRFAX, VA 22031-2225
(703) 698-5220
(703) 573-2351
Mailing address
8500 EXECUTIVE PARK AVE, SUITE 200, FAIRFAX, VA 22031-2225
(703) 698-5220
(703) 573-2351
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0904003266
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0080
CAREFIRST DC
DC
01
—
269409
ANTHEM
VA
01
—
276677-000
MAGELLAN
VA
01
—
4116181
MAMSI
—
01
—
528410
NCPPO
—
01
—
7396420
AETNA
—
Enumeration date
07/18/2005
Last updated
11/10/2011
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