Provider Demographics
NPI:1225880461
Name:ASCENDING ROOT
Entity Type:Organization
Organization Name:ASCENDING ROOT
Other - Org Name:ASCENDING ROOT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARP
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:419-618-3088
Mailing Address - Street 1:5029 E LIBERTY MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-7936
Mailing Address - Country:US
Mailing Address - Phone:843-640-5141
Mailing Address - Fax:
Practice Address - Street 1:5029 E LIBERTY MEADOWS DR
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-7936
Practice Address - Country:US
Practice Address - Phone:843-640-5141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health