Provider Demographics
NPI:1225708837
Name:ROOTED IN STRENGTH LLC
Entity Type:Organization
Organization Name:ROOTED IN STRENGTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WATT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:810-338-6655
Mailing Address - Street 1:7127 E ATHERTON RD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-2403
Mailing Address - Country:US
Mailing Address - Phone:810-338-6655
Mailing Address - Fax:
Practice Address - Street 1:7127 E ATHERTON RD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-2403
Practice Address - Country:US
Practice Address - Phone:810-338-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)