Provider Demographics
NPI:1750169413
Name:ROOTS TO HEALING COUNSELING & WELLNESS LLC
Entity type:Organization
Organization Name:ROOTS TO HEALING COUNSELING & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:330-429-1747
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:NORTH LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:44452-0432
Mailing Address - Country:US
Mailing Address - Phone:330-429-1747
Mailing Address - Fax:
Practice Address - Street 1:11369 MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:NORTH LIMA
Practice Address - State:OH
Practice Address - Zip Code:44452-9782
Practice Address - Country:US
Practice Address - Phone:330-429-1747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty