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NPI Code Detail

MEDICARE: DEEPLY ROOTED FAMILY SERVICES

MEDICARE: DEEPLY ROOTED FAMILY SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1407429251
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEEPLY ROOTED FAMILY SERVICES
Provider Business Mailing Address
First Line : 1 BUFFALO AVE NW STE 201
Second Line :
City : CONCORD
State : NC
Zip : 28025-4004
Country : US
Telephone Number : 980-280-5904
Fax Number :
Provider Business Practice Location Address
First Line : 1 BUFFALO AVE NW STE 201
Second Line :
City : CONCORD
State : NC
Zip : 28025-4004
Country : US
Telephone Number : 980-280-5904
Fax Number :
Authorized Official
Title or Position : OWNER/PSYCHOTHERAPIST
Name : MEGAN BRYANT
Credential : MS, LCMHC
Telephone Number : 980-280-5904
Provider Enumeration Date : 07/20/2021
Last Update Date : 07/20/2021

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Directions to “DEEPLY ROOTED FAMILY SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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