Provider Demographics
NPI:1952935520
Name:ROTHFELD, KENNETH PAUL
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:PAUL
Last Name:ROTHFELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PLUMSTEAD CT
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-4003
Mailing Address - Country:US
Mailing Address - Phone:908-507-6500
Mailing Address - Fax:
Practice Address - Street 1:3 MANOR DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08827-5409
Practice Address - Country:US
Practice Address - Phone:908-537-6815
Practice Address - Fax:908-537-6400
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-23
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00698400101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor