Provider Demographics
NPI:1255147708
Name:NEW ROOTS COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:NEW ROOTS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PANNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-239-4010
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:WARD
Mailing Address - State:AR
Mailing Address - Zip Code:72176-0011
Mailing Address - Country:US
Mailing Address - Phone:501-239-4010
Mailing Address - Fax:501-239-4020
Practice Address - Street 1:318 W 2ND ST
Practice Address - Street 2:
Practice Address - City:WARD
Practice Address - State:AR
Practice Address - Zip Code:72176-7725
Practice Address - Country:US
Practice Address - Phone:501-239-4010
Practice Address - Fax:501-239-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty