Healthcare Provider Details

I. General information

NPI: 1154244481
Provider Name (Legal Business Name): BAYLEIGH ROTH MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 W NORTHERN AVE
PHOENIX AZ
85021-5472
US

IV. Provider business mailing address

25121 N 115TH AVE APT 105
SUN CITY AZ
85373-0005
US

V. Phone/Fax

Practice location:
  • Phone: 888-606-4673
  • Fax:
Mailing address:
  • Phone: 623-251-0492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: