Individual provider · Type 1 NPI

Kandace Roth

Clinical Social Worker · East Peoria, IL

NPI number 1205184884 Active

Practice location

411 E Washington St
East Peoria, IL 61611-2663

Fax (309) 387-2340

Specialties and licenses

Taxonomy	Code	License
Social Worker	104100000X	None listed
Clinical Social Worker Primary	1041C0700X	149.023565 (IL)

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 1205184884

Kandace Roth's National Provider Identifier is 1205184884, issued on Aug 29, 2012. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in East Peoria, IL. The record was last updated on Jul 28, 2021.