| Kelly Rothert, Lisw, Llc | |
|
4041 N High St Suite 402a Columbus OH 43214-3253 | |
| (614) 787-5565 | |
| (844) 335-1293 |
| Full Name | Kelly Rothert, Lisw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4041 N High St, Columbus, Ohio |
| Authorized Official Name and Position | Jennifer Jones (BILLING ADMIN) |
| Authorized Official Contact | 6148649560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Rothert, Lisw, Llc 4041 N High St Suite 402a Columbus OH 43214-3253 Ph: (614) 787-5565 | Kelly Rothert, Lisw, Llc 4041 N High St Suite 402a Columbus OH 43214-3253 Ph: (614) 787-5565 |
| NPI Number | 1851742597 |
|---|---|
| Provider Enumeration Date | 06/23/2016 |
| Last Update Date | 06/23/2016 |
| Medicare PECOS PAC ID | 4486946431 |
|---|---|
| Medicare Enrollment ID | O20160712001206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851742597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I.1502355 (Ohio) | Primary |
| Provider Name | Kelly Lisw Rothert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427490960 PECOS PAC ID: 5193035624 Enrollment ID: I20151112001004 |
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