Marussia Rothenberg Role, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

11137 Issued in MA

Practice address

11 Beech St
Cambridge, MA 02140

Phone

(617) 418-1286

NPI assigned

Sep 14, 2015

Sex

Female

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.

• Pacific Center for Human Growth

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berkeley, CA
  • NPI 1043434095
  NPD (past)
• Pacific Center for Human Growth

  • Community/Behavioral Health Agency
  • Berkeley, CA
  • NPI 1275687717
  NPD (past)

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1447628045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411A HIGHLAND AVE",
            "address_2": "BOX 378",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442516",
            "telephone_number": "617-418-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BEECH ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02140",
            "telephone_number": "617-418-1286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2712 Telegraph Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947051117",
            "country_code": "US",
            "telephone_number": "510-548-8283 x104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 Beech St Apt 3",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021401330",
            "country_code": "US",
            "telephone_number": "617-418-1286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLE",
        "first_name": "MARUSSIA",
        "middle_name": "ROTHENBERG",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2021-03-04",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11137",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marni Roitfarb, MD
• Rebecca Pearl Roitman, RD
• Carmen Elena Rojas, LICSW
• Rahil Amyn Rojiani, MD
• Haleh Rokni, MD
• Nia C. Rollins
• Paul Romain
• Donald Francis Romanelli, MD
• Sabrina Romanoff
• Tatiana Romero-Pantazopoulos, M.D.

• Clinical Psychologist in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.