Active NPI
Lia Angelica Roth, PSYA D
- Clinical Social Worker
- Saint Charles, MO
National Provider Identifier
1306164728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2009030440
- Practice address
- 440 Newkirk Cir
Saint Charles, MO 63303-6720 - Phone
- (314) 714-5227
- NPI assigned
- May 10, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2009030440 | MO | Primary |
Addresses
Primary practice location
440 Newkirk Cir
Saint Charles, MO 63303-6720
Mailing address
440 Newkirk Cir
St Charles, MO 63303-6720
Phone (314) 714-5227
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740512854 | Other | MO | NPI 2 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009030440 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monarch Immigrant Services | Clinical | Past | Accepting new patients |
| Roth Clinic (Dba) | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Saint Louis, MO
- NPI 1063764587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1306164728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 NEWKIRK CIR",
"city": "ST CHARLES",
"state": "MO",
"postal_code": "633036720",
"telephone_number": "314-714-5227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 NEWKIRK CIR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633036720",
"telephone_number": "314-714-5227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "LIA",
"middle_name": "ANGELICA",
"credential": "PSYA D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-10",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2009030440",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI 2",
"identifier": "1740512854",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.