Provider Demographics
NPI:1669298410
Name:RESILIENT ROOTS THERAPEUTIC SERVICES, PLLC
Entity type:Organization
Organization Name:RESILIENT ROOTS THERAPEUTIC SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AALIH
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-872-4930
Mailing Address - Street 1:10275 E OLD US HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-9244
Mailing Address - Country:US
Mailing Address - Phone:570-872-4930
Mailing Address - Fax:
Practice Address - Street 1:10275 E OLD US HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292
Practice Address - Country:US
Practice Address - Phone:570-872-4930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty