Cheryl K Rotherham, M.S., L.C.S.W.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1576-123 Issued in WI

Practice address

840 Willard Dr
Suite 102
Green Bay, WI 54304-5204

Phone

(920) 497-0788

Fax

(920) 497-0792

NPI assigned

Jan 23, 2007

Last updated

Jan 9, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Child and Family Consultants

  • Adolescent and Children Mental Health Clinic/Center
  • Green Bay, WI
  • NPI 1063693273
  NPD (past) Authorized official

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1578617502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 WILLARD DR",
            "address_2": "SUITE 102",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045204",
            "telephone_number": "920-497-0788",
            "fax_number": "920-497-0792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 WILLARD DR",
            "address_2": "SUITE 102",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045204",
            "telephone_number": "920-497-0788",
            "fax_number": "920-497-0792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHERHAM",
        "first_name": "CHERYL",
        "middle_name": "K",
        "credential": "M.S., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1576-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey M Ross, APNP
• Kathleen M Ross, LPC
• Michael A Ross, MD
• Kevin Peter Rosteing, MD, MSMI
• Taylor Rae Rotherham-Decremer, NP
• Kara Jean Rottier, FNP
• Stephanie J Rottier, LPC
• Melissa Roubal
• Roundys Supermarkets Inc (Pick N Save Pharmacy)
• Roundys Supermarkets Inc (Pick N Save Pharmacy)

• Marriage & Family Therapist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.