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KANDACE ROTH
NPI 1205184884
Social Worker - Clinical in East Peoria, IL

Active since August 29, 2012
411 E WASHINGTON ST, EAST PEORIA, IL 61611(309) 282-6704(309) 387-2340 Get Directions Write a Review

NPPES record last updated: July 28, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kandace Roth NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KANDACE ROTH (NPI 1205184884) is an individual clinical provider in East Peoria, Illinois, licensed in Illinois (149.023565) and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1205184884
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKANDACE ROTH
Location Address411 E WASHINGTON STEast Peoria, IL 61611-2663
Mailing Address411 E Washington StEast Peoria, IL 61611-2663 · (309) 282-6704 · Fax (309) 387-2340
Phone(309) 282-6704
Fax(309) 387-2340
Sole ProprietorNo
Enumeration DateAugust 29, 2012
Last NPPES UpdateJuly 28, 2021
NPPES CertifiedJuly 28, 2021
✔ NPI 1205184884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 149.023565
Definition
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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedSocial WorkerTaxonomy 104100000X
411 E WASHINGTON ST, East Peoria, IL 61611
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDSEY THORNTON
Developmental Therapist
411 E WASHINGTON ST
EAST PEORIA, IL 61611
Tazewell County (309) 282-6704
BAILEY HATFILL
Speech-Language Pathologist
411 E WASHINGTON ST
EAST PEORIA, IL 61611
Tazewell County (309) 282-6704
SARAH MOSIER
Developmental Therapist
411 E WASHINGTON ST
EAST PEORIA, IL 61611
Tazewell County (309) 282-6704
AMY KARAS
Speech-Language Pathologist
411 E WASHINGTON ST
EAST PEORIA, IL 61611
Tazewell County (309) 282-6704
MUELLER PEDIATRIC THERAPY, LTD.
Speech-Language Pathologist
411 E WASHINGTON ST
EAST PEORIA, IL 61611
Tazewell County (309) 282-6704
ILANA CRADDOCK LCSW
Social Worker (Clinical)
411 E WASHINGTON ST
EAST PEORIA, IL 61611
Tazewell County (309) 282-6704
JILL JONES
Developmental Therapist
411 E WASHINGTON ST
EAST PEORIA, IL 61611
Tazewell County (309) 282-6704
KELCY IRENE SUYDAM MS
Occupational Therapist
411 E WASHINGTON ST
EAST PEORIA, IL 61611
Tazewell County (309) 282-6704

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kandace Roth's NPI number?

The NPI number for Kandace Roth is 1205184884. It was assigned to this individual provider in the NPPES registry on August 29, 2012.

Where is Kandace Roth located?

Kandace Roth practices at 411 E Washington St, East Peoria, IL 61611. The listed phone number is (309) 282-6704.

What is Kandace Roth's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Kandace Roth was last updated on July 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.