Individual
ANDREA ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
109 W 27TH ST STE 5S, NEW YORK, NY 10001-0265
(833) 351-8255
Mailing address
PO BOX 24449, NEW YORK, NY 10087-0589
(833) 351-8255
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
093829
NY
1041C0700X
Clinical Social Worker
9438
TN
1041C0700X
Clinical Social Worker
I.2405984
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336163963
—
NY
Enumeration date
09/07/2018
Last updated
10/29/2024
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