Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicole Roth

Individual provider Clinical Social Worker · NPI 1124690102

Nicole Roth is a Clinical Social Worker in Brookline, Massachusetts. Practices as a sole proprietor. Licensed in Massachusetts.

Licensed in
MA
In the registry since
2021
Specialties on file
2

Practice location Address checks out

21 Longwood Ave Ste 2
Brookline, MA 02446-5239
Phone: (000) 000-0000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 127260 (MA)
Social Worker Taxonomy 104100000X

Record details

NPI number1124690102
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 11, 2021
Last updated in NPPESJanuary 13, 2026
Certification dateJanuary 13, 2026
Mailing address25 Walnut St Ste 300, Wellesley, MA 02481-2145

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