Individual provider · Type 1 NPI

Raven Alexis Roth, MA, LPC, LAC

Professional Counselor · Wheat Ridge, CO

NPI number 1114529294 Active

Practice location

4350 Wadsworth Blvd Ste 250
Wheat Ridge, CO 80033-4653

Call (970) 310-3406 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XACD.0001568 (CO)
Mental Health Counselor 101YM0800XLPC.0016845 (CO)
Professional Counselor Primary 101YP2500XLPC.0016845 (CO)

Professional Counselor: Definition to come...

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About NPI 1114529294

Raven Alexis Roth, MA, LPC, LAC's National Provider Identifier is 1114529294, issued on Nov 12, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Wheat Ridge, CO. The record was last updated on Jun 18, 2025.