Provider Demographics
NPI:1497366173
Name:ROOTED LANCASTER LLC
Entity Type:Organization
Organization Name:ROOTED LANCASTER LLC
Other - Org Name:ROOTED LANCASTER LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:267-603-6724
Mailing Address - Street 1:1018 N CHRISTIAN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-1900
Mailing Address - Country:US
Mailing Address - Phone:267-603-6724
Mailing Address - Fax:
Practice Address - Street 1:1018 N CHRISTIAN ST STE 205
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-1900
Practice Address - Country:US
Practice Address - Phone:267-603-6724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty