National Provider Identifier
Jonathan Roth
Jonathan Roth is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Ithaca, NY and a listed phone number of (607) 275-5965.
Profile Overview
- NPI
- 1366565913
- Provider Type
- Individual
- Primary Specialty
- Mental Health Counselor
- Enumeration Date
- April 09, 2007
- Last Updated
- September 04, 2018
Practice Location
- 122 W Court St
- Ithaca, NY 14850
Phone: (607) 275-5965
Mailing Address
- PO Box 6632
- Ithaca, NY 14851-6632
Specialties
- Mental Health Counselor (101YM0800X)
- Marriage & Family Therapist (106H00000X)
Full Record
- NPI
- 1366565913
- Entity Type
- Individual
- Last Name
- Roth
- First Name
- Jonathan
- Mailing Street Address
- PO Box 6632
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14851-6632
- Mailing Country
- US
- Mailing Phone
- (415) 564-5117
- Practice Street Address
- 122 W Court St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850
- Practice Country
- US
- Practice Phone
- (607) 275-5965
- Enumeration Date
- April 09, 2007
- Last Updated
- September 04, 2018
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Mental Health Counselor (101YM0800X), Marriage & Family Therapist (106H00000X)