Roth, Leah Elizabeth

Roth, Leah Elizabeth is an individual health care provider with primary practice located at 2333 Knob Creek Rd Suite 11, Johnson City TN 37604-2007. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Roth, Leah Elizabeth can be contacted via phone (423) 952-0500.

Contact Information

Primary practice address
2333 Knob Creek Rd Suite 11 Johnson City TN 37604-2007
Phone: (423) 952-0500
Fax: (423) 952-0005
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3955 Tennessee

Profile Details

NPI number 1124015771
LBN Legal business name Roth, Leah Elizabeth
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124015771 NPPES
Tennessee Other 4085357 BLUECROSS BLUESHIELD
Tennessee Other TN0103 BLUECROSS BLUESHIELD
Tennessee MEDICAID 3927292 BLUECROSS BLUESHIELD

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