Healthcare Provider Details

I. General information

NPI: 1659043610
Provider Name (Legal Business Name): ARIELA MORGAN ROTENGOLD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8737 VENICE BLVD STE 201
LOS ANGELES CA
90034-3258
US

IV. Provider business mailing address

8737 VENICE BLVD STE 201
LOS ANGELES CA
90034-3258
US

V. Phone/Fax

Practice location:
  • Phone: 781-777-5286
  • Fax:
Mailing address:
  • Phone: 347-574-9418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number107337
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number094213
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119590
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: