Provider Demographics
NPI:1538995329
Name:ALTERNATE ROOTS THERAPY & CONSULTATION SERVICES LLC
Entity type:Organization
Organization Name:ALTERNATE ROOTS THERAPY & CONSULTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESROSIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LADC
Authorized Official - Phone:207-295-7998
Mailing Address - Street 1:112 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:MADAWASKA
Mailing Address - State:ME
Mailing Address - Zip Code:04756-1201
Mailing Address - Country:US
Mailing Address - Phone:207-295-7998
Mailing Address - Fax:207-728-9239
Practice Address - Street 1:112 11TH AVE
Practice Address - Street 2:
Practice Address - City:MADAWASKA
Practice Address - State:ME
Practice Address - Zip Code:04756-1201
Practice Address - Country:US
Practice Address - Phone:207-295-7998
Practice Address - Fax:207-728-9239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty