Individual provider Active NPI

Judy B. Roth, LPCC, LICDC

  • Mental Health Counselor
  • Youngstown, OH
National Provider Identifier
1376675884
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E0001469 Issued in OH
Practice address
5500 Market St
Suite 90
Youngstown, OH 44512-2601
Phone
(330) 782-7701
Fax
(330) 782-8785
NPI assigned
Mar 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E0001469 OH Primary

Addresses

Primary practice location

5500 Market St
Suite 90
Youngstown, OH 44512-2601

Mailing address

5500 Market St
Suite 90
Youngstown, OH 44512-2601
Phone (330) 782-7701

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
E0001469OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cope Treatment Centers in Past Accepting new patients
Total Care Psychological & Counseling Services Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376675884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARKET ST",
            "address_2": "SUITE 90",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445122601",
            "telephone_number": "330-782-7701",
            "fax_number": "330-782-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MARKET ST",
            "address_2": "SUITE 90",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445122601",
            "telephone_number": "330-782-7701",
            "fax_number": "330-782-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JUDY",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "credential": "LPCC, LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E0001469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.