Provider Demographics
NPI:1295218675
Name:ROTHMAN, PAMELA (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:ROTHMAN
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 NEWTOWN YARDLEY RD STE 122
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4500
Mailing Address - Country:US
Mailing Address - Phone:215-498-2512
Mailing Address - Fax:
Practice Address - Street 1:760 NEWTOWN YARDLEY RD STE 122
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4500
Practice Address - Country:US
Practice Address - Phone:215-498-2512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010553101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor