Provider Demographics
NPI:1841097870
Name:RESILIENT ROOTS PSYCHIATRY LLC
Entity type:Organization
Organization Name:RESILIENT ROOTS PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:802-238-2289
Mailing Address - Street 1:60 ORR RD
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:VT
Mailing Address - Zip Code:05465-2022
Mailing Address - Country:US
Mailing Address - Phone:802-324-2168
Mailing Address - Fax:
Practice Address - Street 1:60 ORR RD
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:VT
Practice Address - Zip Code:05465-2022
Practice Address - Country:US
Practice Address - Phone:802-238-2289
Practice Address - Fax:866-823-7995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty