Healthcare Provider Details

I. General information

NPI: 1215844790
Provider Name (Legal Business Name): RESTORED ROOTS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8735 DUNWOODY PL STE R
SANDY SPRINGS GA
30350-2995
US

IV. Provider business mailing address

26 CLARENDON AVE
AVONDALE ESTATES GA
30002-1401
US

V. Phone/Fax

Practice location:
  • Phone: 404-913-2258
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ERICA TURNER
Title or Position: OWNER
Credential: LPC
Phone: 301-792-6482