Individual
ELIZABETH N ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
710 N 8TH ST, SPRINGFIELD, IL 62702-6324
(217) 525-1064
(217) 525-1651
Mailing address
710 N 8TH ST, SPRINGFIELD, IL 62702-6324
(217) 525-1064
(217) 525-1651
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.016067
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178.016673
LPC LICENSE
IL
Enumeration date
01/08/2024
Last updated
05/09/2024
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