Provider Demographics
NPI:1740367184
Name:ROTH, BARBARA PRICE (LCPC)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:PRICE
Last Name:ROTH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SUSAN LN
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2527
Mailing Address - Country:US
Mailing Address - Phone:207-712-9986
Mailing Address - Fax:
Practice Address - Street 1:1321 WASHINGTON AVE STE 312
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-3675
Practice Address - Country:US
Practice Address - Phone:207-712-9986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME040953Medicare UPIN
ME273727Medicare UPIN
MEB3PRICEMedicare UPIN
ME24575Medicare UPIN
ME007119Medicare UPIN