Healthcare Provider Details

I. General information

NPI: 1366365231
Provider Name (Legal Business Name): RENEWED & ROOTED COUNSELING, CONSULTING, & EDUCATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 N GERMAN CHURCH RD
INDIANAPOLIS IN
46229-2087
US

IV. Provider business mailing address

11554 SIGNET LN
INDIANAPOLIS IN
46235-9791
US

V. Phone/Fax

Practice location:
  • Phone: 317-978-9875
  • Fax: 317-981-1092
Mailing address:
  • Phone: 317-978-9875
  • Fax: 317-981-1092

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: ADALIAH BROWN
Title or Position: OWNER/THERAPIST
Credential: LMHC
Phone: 317-978-9875