Healthcare Provider Details

I. General information

NPI: 1881896140
Provider Name (Legal Business Name): ROTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 HAZEL PATH, SUITE 3
HENDERSONVILLE TN
35075-3878
US

IV. Provider business mailing address

113 HAZEL PATH STE 3
HENDERSONVILLE TN
37075-3878
US

V. Phone/Fax

Practice location:
  • Phone: 615-822-1116
  • Fax: 615-822-1116
Mailing address:
  • Phone: 615-822-1116
  • Fax: 615-822-1116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number79330
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1541
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number565
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number32
License Number StateTN

VIII. Authorized Official

Name: DR. GILBERT J ROTH
Title or Position: EXECUTIVE DIRECTOR
Credential: D.MIN.
Phone: 615-822-1116