Provider Demographics
NPI:1639898653
Name:ROOTED PATHWAYS COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:ROOTED PATHWAYS COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUAMOUNEH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:217-213-3405
Mailing Address - Street 1:701 DEVONSHIRE DR STE C11
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-7352
Mailing Address - Country:US
Mailing Address - Phone:217-213-3405
Mailing Address - Fax:217-403-9556
Practice Address - Street 1:701 DEVONSHIRE DR STE C11
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-7352
Practice Address - Country:US
Practice Address - Phone:217-213-3405
Practice Address - Fax:217-403-9556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty