Provider Demographics
NPI:1790011153
Name:ROTHMAN, ERIC D (LPC, ATR-BC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:D
Last Name:ROTHMAN
Suffix:
Gender:M
Credentials:LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1984 ISAAC NEWTON SQ W
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5038
Mailing Address - Country:US
Mailing Address - Phone:202-812-4325
Mailing Address - Fax:
Practice Address - Street 1:3000 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2509
Practice Address - Country:US
Practice Address - Phone:202-812-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC13964101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional