Healthcare Provider Details

I. General information

NPI: 1922610856
Provider Name (Legal Business Name): RODH JOSEPH LAMOTHE MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 NW 5TH ST
OKEECHOBEE FL
34972-2565
US

IV. Provider business mailing address

4951 ROTHSCHILD DR
CORAL SPRINGS FL
33067-4140
US

V. Phone/Fax

Practice location:
  • Phone: 561-616-8411
  • Fax: 561-616-8412
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: