Healthcare Provider Details
I. General information
NPI: 1881538031
Provider Name (Legal Business Name): ROOTED FOR GROWTH COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 HIGHLAND AVE
CARROLLTON KY
41008-1016
US
IV. Provider business mailing address
1985 HIGHWAY 467
WORTHVILLE KY
41098-9756
US
V. Phone/Fax
- Phone: 502-480-1096
- Fax:
- Phone: 502-480-1096
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIMBERLY
WATKINS
Title or Position: OWNER
Credential: LPCC
Phone: 502-480-1096