Individual provider Active NPI

Melissa Rose Rothman, LMSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1750852612
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104705 Issued in NY
Practice address
102 Pilling St
Brooklyn, NY 11207-1610
Phone
(978) 821-1374
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 104705 NY Primary

Addresses

Primary practice location

102 Pilling St
Brooklyn, NY 11207-1610

Mailing address

102 Pilling St
Brooklyn, NY 11207-1610

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
104705NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1750852612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PILLING ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112071610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PILLING ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112071610",
            "telephone_number": "978-821-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHMAN",
        "first_name": "MELISSA",
        "middle_name": "ROSE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "104705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.