Provider Demographics
NPI:1811782188
Name:ROOTED RESILIENCE WELLNESS PLLC
Entity type:Organization
Organization Name:ROOTED RESILIENCE WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:986-235-7612
Mailing Address - Street 1:1015 W OWYHEE ST
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634-2207
Mailing Address - Country:US
Mailing Address - Phone:986-235-7612
Mailing Address - Fax:
Practice Address - Street 1:2200 S ORCHARD ST STE 201
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-3713
Practice Address - Country:US
Practice Address - Phone:986-235-7612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)