Provider Demographics
NPI:1659926913
Name:DEEP ROOTS COUNSELING, LLC
Entity Type:Organization
Organization Name:DEEP ROOTS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:JUERLING
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:509-460-1781
Mailing Address - Street 1:3969 E ARAPAHOE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2071
Mailing Address - Country:US
Mailing Address - Phone:509-460-1781
Mailing Address - Fax:
Practice Address - Street 1:3969 E ARAPAHOE RD STE 210
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2071
Practice Address - Country:US
Practice Address - Phone:509-460-1781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-05
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty