Mitchell Roth, M.S, J.D., PSYD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 14604 Issued in FL

Practice address

11905 Mont Lake Dr
Boynton Beach, FL 33437-4918

Phone

(561) 740-5642

Fax

(561) 634-2862

NPI assigned

May 1, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor, 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.

• Mitchell Roth

  • Mental Health Counselor
  • Boynton Beach, FL
  • NPI 1699263327
  NPD (past) Authorized official

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

{
    "created_epoch": "1462060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1760837470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11905 MONT LAKE DR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334374918",
            "telephone_number": "561-740-5642",
            "fax_number": "561-634-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 MONT LAKE DR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334374918",
            "telephone_number": "561-740-5642",
            "fax_number": "561-634-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MITCHELL",
        "credential": "M.S, J.D., PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-01",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 14604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "MH 14604",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.rothmentalhealth.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "200 Knuth Rd Ste 254",
            "city": "Boynton Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334364637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donna M Ross, LCSW
• Michael David Ross, M.D.
• Reagan Lindsay Ross, MD
• Rostislav Ignatov, M.D., P.a.
• Maryelizabeth Anne Roth, M.D.
• William I Roth, M.D.
• David J Rothfeld, M.D,
• Nicole Alyson Rothman, DC
• Monica Deshaun Roundtree Cleckley, DNP, APRN-BC, NP-C
• Sheila Rousseau, CRNA

• Mental Health Counselor in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.