Provider Demographics
NPI:1316546906
Name:ROTHMAN, ALEXANDER JORDAN (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JORDAN
Last Name:ROTHMAN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 E PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2142
Mailing Address - Country:US
Mailing Address - Phone:717-283-5910
Mailing Address - Fax:
Practice Address - Street 1:30 S VALLEY RD STE 102
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1469
Practice Address - Country:US
Practice Address - Phone:443-856-8122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW137349104100000X
PACW0256541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker