Nicole Rooth, NCC, LPC, LCADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37PC00587600 Issued in NJ

Practice address

187 Fayette St
Perth Amboy, NJ 08861-4140

Phone

(732) 410-7102

NPI assigned

Mar 14, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1023577533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 W 31ST ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023903",
            "telephone_number": "201-315-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 FAYETTE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614140",
            "telephone_number": "732-410-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOTH",
        "first_name": "NICOLE",
        "credential": "NCC, LPC, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00262400",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00587600",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00587600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Perth Amboy, NJ
• Providers in Perth Amboy, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.