Provider Demographics
NPI:1659043610
Name:ROTENGOLD, ARIELA MORGAN (LCSW)
Entity Type:Individual
Prefix:
First Name:ARIELA
Middle Name:MORGAN
Last Name:ROTENGOLD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8737 VENICE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-3258
Mailing Address - Country:US
Mailing Address - Phone:347-574-9418
Mailing Address - Fax:
Practice Address - Street 1:8737 VENICE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-3258
Practice Address - Country:US
Practice Address - Phone:781-777-5286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110377104100000X
NY107337104100000X
NY0942131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker