Provider Demographics
NPI:1467239749
Name:ROOTS OF REGULATION COUNSELING LLC
Entity Type:Organization
Organization Name:ROOTS OF REGULATION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ADAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-627-6417
Mailing Address - Street 1:25047 S BLACKTHORNE RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:IL
Mailing Address - Zip Code:60442-9189
Mailing Address - Country:US
Mailing Address - Phone:773-627-6417
Mailing Address - Fax:
Practice Address - Street 1:25047 S BLACKTHORNE RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:IL
Practice Address - Zip Code:60442-9189
Practice Address - Country:US
Practice Address - Phone:773-627-6417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty