Jeffrey Roth, PHD PSYCHOLOGY

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

B1-0000251 Issued in DE

Practice address

240 N James St
Suites 104-106
Wilmington, DE 19804-3169

Phone

(302) 633-0301

Fax

(302) 633-0331

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1598886558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N JAMES ST",
            "address_2": "SUITES 104-106",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198043169",
            "telephone_number": "302-633-0301",
            "fax_number": "302-633-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N JAMES ST",
            "address_2": "SUITES 104-106",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198043169",
            "telephone_number": "302-633-0301",
            "fax_number": "302-633-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JEFFREY",
        "credential": "PHD PSYCHOLOGY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "B1-0000251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G02128T02",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000342567",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Ross, D.C.
• Lisa Pozzi Ross, PT, DPT, PCS
• Maia Rosser
• Meaghan Nancy Roszyk, DO
• Roth Chiropractic LLC
• Zachary James Roth, D.C.
• Ellesse Rougier, LMSW
• Suzanne M Rouleau, LCSW
• David Rovner, RPH
• Jennifer Ann Rovner, APN

• Mental Health Counselor in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Mental Health Counselor in Delaware

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