Provider Demographics
NPI:1225702715
Name:ROOTED AWARENESS PLLC
Entity Type:Organization
Organization Name:ROOTED AWARENESS PLLC
Other - Org Name:ROOTED AWARENESS, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-823-0518
Mailing Address - Street 1:1019 LEESE LN
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-6221
Mailing Address - Country:US
Mailing Address - Phone:406-223-1737
Mailing Address - Fax:
Practice Address - Street 1:212 MAIN ST
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-2111
Practice Address - Country:US
Practice Address - Phone:406-823-0518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty