Provider Demographics
NPI:1114575834
Name:ROOTED WORKS
Entity Type:Organization
Organization Name:ROOTED WORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAN
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:201-723-6972
Mailing Address - Street 1:800 RIVERVIEW DR STE 108
Mailing Address - Street 2:
Mailing Address - City:BRIELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08730-1749
Mailing Address - Country:US
Mailing Address - Phone:201-723-6972
Mailing Address - Fax:
Practice Address - Street 1:800 RIVERVIEW DR STE 108
Practice Address - Street 2:
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730-1749
Practice Address - Country:US
Practice Address - Phone:201-723-6972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty