Marc Roth, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39001276A Issued in IN

Practice address

1930 W Lincoln Ave
Goshen, IN 46526-5907

Phone

(574) 534-2161

Fax

(574) 534-3887

NPI assigned

Oct 13, 2005

Last updated

Dec 18, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Divinity

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Living Well Behavioral Health, PC

  • Clinical Psychologist
  • Goshen, IN
  • NPI 1659477081
  NPD (past)

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1184613028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265907",
            "telephone_number": "574-534-2161",
            "fax_number": "574-534-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MARC",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001276A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Kaye Ropp, LSW
• Riley Rosenthal
• Sarah Elizabeth Rospenda
• Curtis Ross
• Joanna Belle Roth, M.S., A.C.N.P.-B.C.
• Lisa Rotroff
• Sharmila Roy Chowdhury, MD
• Alfredo Rubio Jr.
• Alyssa Marie Ruisard
• Faith Ruiz

• Mental Health Counselor in Goshen, IN
• Providers in Goshen, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.