Charles P Roth, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS-004849-L Issued in PA

Practice address

412 E King St
Malvern, PA 19355-3004

Phone

(610) 647-8730

Fax

(610) 647-8921

NPI assigned

Jan 12, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Lynne J Freeman PSYD PC

  • Clinical Psychologist
  • Langhorne, PA
  • NPI 1841767555
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902956501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 E KING ST",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553004",
            "telephone_number": "610-647-8730",
            "fax_number": "610-647-8921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 E KING ST",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553004",
            "telephone_number": "610-647-8730",
            "fax_number": "610-647-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "CHARLES",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS-004849-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Rodriguez, CCMA; CPT
• Brian Scott Rogers, M.D.
• Allison Roman
• Desiree Kenyetta Ross, LCSW
• Anna Rossis, DMD
• Row Psychiatric Services, LLC
• Ruggiero Orthopaedic Assoc LTD P C
• Ruggiero Orthopaedic Associates LTD., P.C.
• Ruggiero Orthopaedic Associates LTD., P.C.
• Ruggiero Orthopaedic Associates LTD., P.C.

• Psychologist in Malvern, PA
• Providers in Malvern, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.