Provider Demographics
NPI:1316546906
Name:ROTHMAN, ALEXANDER JORDAN (LSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JORDAN
Last Name:ROTHMAN
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2519 BROWN ST FL 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1810
Mailing Address - Country:US
Mailing Address - Phone:717-283-5910
Mailing Address - Fax:
Practice Address - Street 1:30 S VALLEY RD STE 12
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1450
Practice Address - Country:US
Practice Address - Phone:443-856-8122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW137349104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker