Healthcare Provider Details

I. General information

NPI: 1548194467
Provider Name (Legal Business Name): ROOTED IN WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 COBBLERS WAY
WATERLOO IN
46793-9489
US

IV. Provider business mailing address

325 COBBLERS WAY
WATERLOO IN
46793-9489
US

V. Phone/Fax

Practice location:
  • Phone: 616-490-6303
  • Fax:
Mailing address:
  • Phone: 616-490-6303
  • 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: CAITLYNN EISEL
Title or Position: FOUNDER
Credential: LMSW
Phone: 260-226-3238