Provider Demographics
NPI:1265247704
Name:RESILIENT ROOTS COUNSELING, LLC
Entity type:Organization
Organization Name:RESILIENT ROOTS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LUDLOW
Authorized Official - Last Name:HOLFELTZ
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC, LPC-MHSP
Authorized Official - Phone:801-915-3882
Mailing Address - Street 1:1111 E DRAPER PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9077
Mailing Address - Country:US
Mailing Address - Phone:801-829-1508
Mailing Address - Fax:
Practice Address - Street 1:1111 E DRAPER PKWY STE 103
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9077
Practice Address - Country:US
Practice Address - Phone:801-829-1508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty