Jacquelyn Rothman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW015664 Issued in PA

Practice address

130 Buffalo Rd
Suite 204
Lewisburg, PA 17837-1159

Phone

(570) 524-5294

Fax

(570) 577-1957

NPI assigned

Apr 25, 2007

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

Other names 1

• Jaxi Rothman Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1801015052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BUFFALO RD",
            "address_2": "SUITE 204",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178371159",
            "telephone_number": "570-524-5294",
            "fax_number": "570-577-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BUFFALO RD",
            "address_2": "SUITE 204",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178371159",
            "telephone_number": "570-524-5294",
            "fax_number": "570-577-1957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHMAN",
        "first_name": "JACQUELYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAXI",
            "last_name": "ROTHMAN",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Farrah Lee Rose
• Caroline Elizabeth Ross, LSW, MSW
• Danielle Ross
• Kara Nicole Rothermel, MSPT
• Lori Kaye Rothermel, M.D.
• Keith A Rouse, DPM
• Deborah Rowe, MS,CCC-SLP
• Malayna Marie Rowe, PA-C
• Marsha Rowe
• Alexander Seth Roy IV, PA-C

• Clinical Social Worker in Lewisburg, PA
• Providers in Lewisburg, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.