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Individual

MR. JAMES JOSEPH ROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.ED., LPC, LISAC,

Contact information

Practice address
16260 N 71ST ST, SCOTTSDALE, AZ 85254-4900
(480) 966-3991
(480) 966-4032
Mailing address
PO BOX 10701, SCOTTSDALE, AZ 85271-0701
(480) 966-3991
(480) 966-4032

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-0769
AZ
101YP2500X
Professional Counselor
LPC-2419
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12078741
CAQH
AZ
Enumeration date
08/19/2011
Last updated
08/19/2011
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