Provider Demographics
NPI:1770319576
Name:DR. ROFFMAN & ASSOCIATES
Entity type:Organization
Organization Name:DR. ROFFMAN & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:410-561-3651
Mailing Address - Street 1:7936 STARBURST DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3036
Mailing Address - Country:US
Mailing Address - Phone:410-292-2743
Mailing Address - Fax:
Practice Address - Street 1:10400 STEVENSON RD STE 102
Practice Address - Street 2:
Practice Address - City:STEVENSON
Practice Address - State:MD
Practice Address - Zip Code:21153-0600
Practice Address - Country:US
Practice Address - Phone:410-561-3651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty