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NPI Code Detail

MEDICARE: FORGING ROOTS

MEDICARE: FORGING ROOTS
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1942162730
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORGING ROOTS
Provider Business Mailing Address
First Line : PO BOX 150603
Second Line :
City : LUFKIN
State : TX
Zip : 75915-0603
Country : US
Telephone Number : 936-252-7242
Fax Number :
Provider Business Practice Location Address
First Line : 520 S 1ST ST
Second Line :
City : LUFKIN
State : TX
Zip : 75901-3828
Country : US
Telephone Number : 936-252-7242
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. STEPHANIE MOORE KNOX
Credential : LCSW
Telephone Number : 936-252-7242
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/01/2025

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Directions to “FORGING ROOTS ” Practice Location

Language Start Address Practice Location
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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