| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JULIE ROTH | 1992389605 | 2021-05-09 |
Julie Roth is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1992389605. Registration indicates Julie Roth is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Professional, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Professional, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Julie Roth LCPC |
| Practice Office Address | 208 S 1ST AVE MORTON, IL US |
| Practice Office Telephone | 3095856061 |
| Mailing Address | 147 MAPLE RIDGE DR MORTON, IL 615501121 US |
| Business Telephone | 3097126396 |
| Code | Practice | License No State |
|---|---|---|
| 101YP2500X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Professional Behavioral Health/Substance Abuse/Psychiatry Counselor Professional Behavioral Health & Social Service Providers Counselor | 180007397
IL |