Provider Demographics
NPI:1467025783
Name:ROOTED HOPE COUNSELING AND CONSULTING PLC
Entity Type:Organization
Organization Name:ROOTED HOPE COUNSELING AND CONSULTING PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-871-4595
Mailing Address - Street 1:3408 W FAIRFAX ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-5373
Mailing Address - Country:US
Mailing Address - Phone:479-871-4595
Mailing Address - Fax:
Practice Address - Street 1:3408 W FAIRFAX ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-5373
Practice Address - Country:US
Practice Address - Phone:479-871-4595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)