Provider Demographics
NPI:1174688550
Name:ROTHERMEL, CHARLES A (PSYD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:ROTHERMEL
Suffix:
Gender:M
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 AUCTION RD
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-9172
Mailing Address - Country:US
Mailing Address - Phone:717-201-8509
Mailing Address - Fax:
Practice Address - Street 1:735 AUCTION RD
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-9172
Practice Address - Country:US
Practice Address - Phone:717-201-8509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000269106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist