Provider Demographics
NPI:1588558498
Name:ROOTED PSYCHOTHERAPY AND COUNSELING
Entity type:Organization
Organization Name:ROOTED PSYCHOTHERAPY AND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOILER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-351-1014
Mailing Address - Street 1:782 ROSEVINE LN
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-7064
Mailing Address - Country:US
Mailing Address - Phone:856-375-2440
Mailing Address - Fax:303-997-5001
Practice Address - Street 1:782 ROSEVINE LN
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-7064
Practice Address - Country:US
Practice Address - Phone:856-375-2440
Practice Address - Fax:303-997-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty