person
Mr. Dale Leon Roth, MDVDAVISLMHPLAPC
Mental Health Counselor in Columbus, Nebraska
NPI 1023105756

Dale Leon Roth is a Mental Health Counselor based in Norfolk, NE and is specialized in Mental Health. Dale Leon Roth practices in Columbus, NE and has the professional credentials of MDVDAVISLMHPLAPC. The NPI Number for Dale Leon Roth is 1023105756 and holds a License No. 562 (Nebraska).

The current practice location address for Dale Leon Roth is 4432 Sunrise Place, Columbus, NE and can be reached out via phone at 402-564-9994 and via fax at 402-562-6458. You can also correspond with Dale Leon Roth through the mailing address at 600 S 13TH STREET, NORFOLK, NE - 68701 (mailing address contact number: 402-370-3140).

Location: 4432 Sunrise Place, Columbus, NE, 68701
person
Provider Profile Details
NPI Number
1023105756
Provider Name
Dale Leon Roth
Credential
MDVDAVISLMHPLAPC
Provider Entity Type
Individual
Gender
Male
Address
4432 Sunrise Place, Columbus, NE, 68701
Phone Number
402-564-9994
Fax Number
402-562-6458
Provider Enumeration Date
10/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
97061 01 BCBS AUX
85330 01 BCBS
institution
Provider Business Practice Location Address Details
Address
4432 Sunrise Place
City
State
Zip
68601
Phone Number
402-564-9994
Fax Number
402-562-6458
person
Provider Business Mailing Address Details
Address
4432 Sunrise Place
City
State
Zip
68601
Phone Number
402-564-9994
Fax Number
402-562-6458
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
2512 (Nebraska)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
562 (Nebraska)
Definition
Definition to come...
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