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General NPI Number Information
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NPI Number | 1285022129
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Entity Type | Individual
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Provider Name | RACHEL ROTH LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/30/2014
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 134 NORTH LASALLE STREET SUITE 2200
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City | CHICAGO
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State | IL
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Zip | 60602
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Country | US
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Telephone | 516-508-8160
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Fax |
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Provider Business Mailing Address
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Address Line | 14114 ASTER AVE
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City | WELLINGTON
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State | FL
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Zip | 33414-8513
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Country | US
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Telephone | 516-508-8160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 093043
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License Number State | NY
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