Provider Demographics
NPI:1518196104
Name:GROWING ROOTS LLC
Entity Type:Organization
Organization Name:GROWING ROOTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL PSYCHOLOGIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SCHINAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:603-238-3149
Mailing Address - Street 1:85 MAIN ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-1500
Mailing Address - Country:US
Mailing Address - Phone:603-238-3149
Mailing Address - Fax:
Practice Address - Street 1:85 MAIN ST
Practice Address - Street 2:SUITE 305
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1500
Practice Address - Country:US
Practice Address - Phone:603-238-3149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1166103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0010996Medicare Oscar/Certification