Individual provider Active NPI

Andrea C Rothberg, LMFT

  • Marriage & Family Therapist
  • Concord, NH
National Provider Identifier
1851674063
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
217 Issued in NH
Practice address
70 Commercial St
Concord, NH 03301-5094
Phone
(603) 766-0613
NPI assigned
Sep 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 217 NH Primary

Addresses

Primary practice location

70 Commercial St
Concord, NH 03301-5094

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630

Other identifiers 1

IdentifierTypeStateIssuer
004235918MedicaidCT

Other names 1

  • Andrea C Teixeira Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Andrea.rothberg@lifestance.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20240131004018 NH Practitioner - Marriage and Family Therapist 4981057460 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
217NHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Community Council of Nashua NH, Inc. PastSince Mar 27, 2011 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ccn.andreakreisz@140126.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1851674063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 COMMERCIAL ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033015094",
            "telephone_number": "603-766-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBERG",
        "first_name": "ANDREA",
        "middle_name": "C",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-23",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NH",
            "license": "217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235918",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Andrea.rothberg@lifestance.com",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "70 Commercial St",
            "city": "Concord",
            "state": "NH",
            "country_code": "US",
            "postal_code": "033015094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "TEIXEIRA",
            "middle_name": "C",
            "credential": "MFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.