Bradley William Roth, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

27.002034 Issued in CT

Practice address

57 Crestwood Rd
Milford, CT 06460-6923

Phone

(203) 888-0462

Fax

(203) 888-1465

NPI assigned

Nov 26, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rimmon Pond Counseling LLC

  • Mental Health Counselor
  • Seymour, CT
  • NPI 1932325669
  NPD (past)

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1386114015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 CRESTWOOD RD",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064606923",
            "telephone_number": "203-877-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 CRESTWOOD RD",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064606923",
            "telephone_number": "203-888-0462",
            "fax_number": "203-888-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "BRADLEY",
        "middle_name": "WILLIAM",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-26",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "27.002034",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "27.002034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claribel Rosado, MFT
• Ilene Linda Rosenberg, MD
• Susan Rosenberger, LCSW
• Philip B Rosenthal, PH.D.
• Ainsley F Rossi, DPT
• Benjamin Rothchild
• Victoria Rothenhausen, DC
• Jeffrey Roy
• Tony Roy, M.B.B.S, M.D
• Elizabeth Rubino, LPC

• Marriage & Family Therapist in Milford, CT
• Providers in Milford, CT by specialty
• Marriage & Family Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.