Healthcare Provider Details

I. General information

NPI: 1932039658
Provider Name (Legal Business Name): ROOTED BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GROSSMAN DR STE 205
BRAINTREE MA
02184-4947
US

IV. Provider business mailing address

150 GROSSMAN DRIVE, SUITE 205 MAIL NUMBER #6
BRAINTREE MA
02184
US

V. Phone/Fax

Practice location:
  • Phone: 617-249-4955
  • Fax:
Mailing address:
  • Phone: 617-249-4955
  • Fax:

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: EVA GONZALEZ CAREY
Title or Position: OWNER
Credential: LMHC
Phone: 818-932-5955