Individual provider · Type 1 NPI
Nicole Roth
Clinical Social Worker · Brookline, MA
Practice location
21 Longwood Ave Ste 2
Brookline, MA 02446-5239
Mailing address
25 Walnut St Ste 300
Wellesley, MA 02481-2145
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | 127260 (MA) |
| Social Worker | 104100000X | None listed |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
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About NPI 1124690102
Nicole Roth's National Provider Identifier is 1124690102, issued on Jul 11, 2021. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Brookline, MA. The record was last updated on Jan 13, 2026.