| Jonathan Roth, | |
|
122 W Court St, Ithaca, NY 14850 | |
| (607) 275-5965 | |
| Not Available |
| Full Name | Jonathan Roth |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 122 W Court St, Ithaca, New York |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366565913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 86401 (California) | Secondary |
| 101YM0800X | Counselor - Mental Health | 005266 (New York) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Roth, Po Box 6632, Ithaca, NY 14851-6632 Ph: (415) 564-5117 | Jonathan Roth, 122 W Court St, Ithaca, NY 14850 Ph: (607) 275-5965 |
Peter Dodge, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 334 W State St, Ithaca, NY 14850 Phone: 607-273-5500 Fax: 607-273-1277 | |
Andrea Arden Gerding, MSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 201 E Green St Fl 5, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280 | |
Mrs. Amy Abbasov, M.ED. LPC-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 23 Besemer Ln, Ithaca, NY 14850 Phone: 806-236-4156 | |
Stacy Cangelosi Mike, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Green St, Suite 500, Ithaca, NY 14850 Phone: 607-274-6288 | |
Mr. Allen John Agnew, CASAC NYS 13121 Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Green St, Suite 500, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280 | |
Vanessa Hendrickson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 E Green St Ste 500, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280 | |
Mr. Colin Andrew Polnitsky, MSW INTERN Counselor Medicare: Medicare Enrolled Practice Location: 201 E Green St, Ithaca, NY 14850 Phone: 607-274-6288 Fax: 607-274-6280 |