Provider Demographics
NPI:1750927281
Name:ROOTED WELLNESS THERAPY, PLLC
Entity type:Organization
Organization Name:ROOTED WELLNESS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEME
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:971-319-4846
Mailing Address - Street 1:231 N THIRD AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1418
Mailing Address - Country:US
Mailing Address - Phone:971-319-4846
Mailing Address - Fax:208-742-0170
Practice Address - Street 1:231 N THIRD AVE STE 207
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1418
Practice Address - Country:US
Practice Address - Phone:971-319-4846
Practice Address - Fax:208-742-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)