Jonathan Roth

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005266 Issued in NY

Practice address

122 W Court St
Ithaca, NY 14850

Phone

(607) 275-5965

NPI assigned

Apr 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1366565913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6632",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148516632",
            "telephone_number": "415-564-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W COURT ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-275-5965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Hyde St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941095996",
            "country_code": "US",
            "telephone_number": "415-673-5700",
            "fax_number": "415-292-7140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JONATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "86401",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Gail Rosen, LCSW
• Jenny Ellen Ross, NP-C
• Lori Rossi, LMT
• Jenai Rossow, LCSW
• Izabella Roth
• Judith Rothenberg, LCSW-R
• Alison Rotolo
• Sarah Rose Rubenstein-Gillis, LMSW
• Angela Joan Rubineau, MD
• Alica Rucekova, MD

• Mental Health Counselor in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.