Provider Demographics
NPI:1174073480
Name:ROOTED IN LOVE COUNSELING SERVICES
Entity type:Organization
Organization Name:ROOTED IN LOVE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:PILLOW
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC, CAADC
Authorized Official - Phone:810-399-6603
Mailing Address - Street 1:1308 RAE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458-1751
Mailing Address - Country:US
Mailing Address - Phone:810-399-6603
Mailing Address - Fax:
Practice Address - Street 1:3397 WINDLAND DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-1764
Practice Address - Country:US
Practice Address - Phone:810-399-6603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101YA0400X
MI6401014779101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty