Provider Demographics
NPI:1497067763
Name:ROETHLING, ELIZABETH ANN (LPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:ROETHLING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5791
Mailing Address - Country:US
Mailing Address - Phone:484-644-5975
Mailing Address - Fax:
Practice Address - Street 1:SUEDLAGER GEB 1801
Practice Address - Street 2:
Practice Address - City:VILLSECK
Practice Address - State:BAVARIA
Practice Address - Zip Code:92249
Practice Address - Country:DE
Practice Address - Phone:307-752-9938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY979101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional