Provider Demographics
NPI:1174043848
Name:ROOTED COUNSELING, LLC
Entity Type:Organization
Organization Name:ROOTED COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIUPPONI
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:724-454-9024
Mailing Address - Street 1:216 S JENISON AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48915-1758
Mailing Address - Country:US
Mailing Address - Phone:724-454-9024
Mailing Address - Fax:
Practice Address - Street 1:300 BAILEY ST STE 2
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-4444
Practice Address - Country:US
Practice Address - Phone:724-454-9024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-23
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)