Healthcare Provider Details

I. General information

NPI: 1487563698
Provider Name (Legal Business Name): ROOTED IN RESILIENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 W CORONA AVE STE 125
PUEBLO CO
81004-1219
US

IV. Provider business mailing address

PO BOX 52
RYE CO
81069-0052
US

V. Phone/Fax

Practice location:
  • Phone: 719-470-2744
  • Fax: 833-907-5394
Mailing address:
  • Phone: 719-470-2744
  • Fax: 833-907-5394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHERYL WEGELIN
Title or Position: OWNER
Credential: LCSW
Phone: 719-470-2744