Provider Demographics
NPI:1740558907
Name:ROTHWELL, MARY K (LPC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:K
Last Name:ROTHWELL
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 1:33 HARRISON DR
Mailing Address - Street 2:
Mailing Address - City:EAST BERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17316-9213
Mailing Address - Country:US
Mailing Address - Phone:717-808-6407
Mailing Address - Fax:
Practice Address - Street 1:2133 MARKET ST STE 227
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4733
Practice Address - Country:US
Practice Address - Phone:717-219-4105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001121101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional