Roth, Marvin D

Roth, Marvin D is an individual health care provider with primary practice located at 25 N Spruce St , Colorado Springs CO 80905-1436. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Roth, Marvin D can be contacted via phone (719) 667-5591.

Contact Information

Primary practice address
25 N Spruce St Colorado Springs CO 80905-1436
Phone: (719) 667-5591
Fax: (719) 667-4470
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 989316 Colorado

Profile Details

NPI number 1902873581
LBN Legal business name Roth, Marvin D
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2006
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 1902873581 NPPES
Colorado Other 209 PIKES PEAK

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