MEDICARE: ROOTS MENTAL HEALTH COUNSELING PLLC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1952250334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROOTS MENTAL HEALTH COUNSELING PLLC

Provider Business Mailing Address
First Line	:	2704 HEATH AVE APT 1
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-7575
Country	:	US
Telephone Number	:	914-514-7223
Fax Number	:

Provider Business Practice Location Address
First Line	:	2704 HEATH AVE APT 1
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-7575
Country	:	US
Telephone Number	:	914-514-7223
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YARISBEL SANTOS
Credential	:	LMHC
Telephone Number	:	914-514-7223

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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