Healthcare Provider Details

I. General information

NPI: 1255269205
Provider Name (Legal Business Name): ROOTED DANDELION COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9922 PECAN HICKORY WAY
ORLANDO FL
32832-3603
US

IV. Provider business mailing address

7157 NARCOOSSEE RD # 1536
ORLANDO FL
32822-5533
US

V. Phone/Fax

Practice location:
  • Phone: 689-500-1611
  • Fax:
Mailing address:
  • Phone: 689-500-1611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KACIE LYNN MACDONALD
Title or Position: OWNER/CLINICIAN
Credential: LCSW
Phone: 689-500-1611