Provider Demographics
NPI:1407462450
Name:THE ROOT CAUSATION LLC
Entity Type:Organization
Organization Name:THE ROOT CAUSATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEAMPHRA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC
Authorized Official - Phone:810-219-1773
Mailing Address - Street 1:550 CHAMBERLAIN ST APT 1008
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-1785
Mailing Address - Country:US
Mailing Address - Phone:810-219-1773
Mailing Address - Fax:
Practice Address - Street 1:550 CHAMBERLAIN ST APT 1008
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-1785
Practice Address - Country:US
Practice Address - Phone:810-219-1773
Practice Address - Fax:810-820-9438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty