Healthcare Provider Details

I. General information

NPI: 1528771318
Provider Name (Legal Business Name): MEGAN ELISABETH ROTHERMEL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2022
Last Update Date: 12/27/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 PAXTON PL STE 102
LITITZ PA
17543-8279
US

IV. Provider business mailing address

1223 ELM AVE
LANCASTER PA
17603-4838
US

V. Phone/Fax

Practice location:
  • Phone: 256-226-1571
  • Fax:
Mailing address:
  • Phone: 256-226-1571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW139783
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: