Provider Demographics
NPI:1245106491
Name:ROOTED WILLOW WELLNESS LLC
Entity type:Organization
Organization Name:ROOTED WILLOW WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GERRISH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-681-7430
Mailing Address - Street 1:67 LAKEVIEW HTS
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:CT
Mailing Address - Zip Code:06249-2219
Mailing Address - Country:US
Mailing Address - Phone:860-681-7430
Mailing Address - Fax:
Practice Address - Street 1:63 NORWICH AVE STE 202
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1242
Practice Address - Country:US
Practice Address - Phone:860-245-9649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)