Provider Demographics
NPI:1649473604
Name:ROTHSCHILD, CAROL HARRIS (MS LMHC LMFT)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:HARRIS
Last Name:ROTHSCHILD
Suffix:
Gender:F
Credentials:MS LMHC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 JAMES ST.
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203
Mailing Address - Country:US
Mailing Address - Phone:315-422-0671
Mailing Address - Fax:315-422-2734
Practice Address - Street 1:770 JAMES ST.
Practice Address - Street 2:SUITE 215
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203
Practice Address - Country:US
Practice Address - Phone:315-422-0671
Practice Address - Fax:315-422-2734
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001790101YM0800X
NY000210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001790OtherLMHC
NY000210OtherLMFT
NY01706147Medicaid
NY56711Medicare ID - Type Unspecified