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1104913375 NPI number — JUDITH S ROTHENBERG MSW, LCSW

NPI Number: 1104913375
Health Care Provider/Practitioner: JUDITH S ROTHENBERG MSW, LCSW

Information about “1104913375” NPI (JUDITH S ROTHENBERG MSW, LCSW) exists in 1104913375 in HTML format HTML  |  1104913375 in plain Text format TXT  |  1104913375 in PDF (Portable Document Format) PDF  |  1104913375 in an XML format XML  formats.

NPI Number : 1104913375 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104913375",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ROTHENBERG",
    "FirstName": "JUDITH",
    "MiddleName": "S",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MSW, LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ROTHENBERG",
    "OtherFirstName": "JUDITH",
    "OtherMiddleName": "S",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LCSW",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "13199 SE SPYGLASS CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOBE SOUND",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33455-7244",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "772-284-4147",
    "MailingAddressFaxNumber": "772-545-3494",
    "FirstLinePracticeLocationAddress": "1080 E INDIANTOWN RD",
    "SecondLinePracticeLocationAddress": "SUITE. 104A",
    "PracticeLocationAddressCityName": "JUPITER",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33477-5100",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "772-284-4147",
    "PracticeLocationAddressFaxNumber": "772-545-3494",
    "EnumerationDate": "10/06/2006",
    "LastUpdateDate": "09/09/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "SW 5032",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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