Healthcare Provider Details

I. General information

NPI: 1821912064
Provider Name (Legal Business Name): REFLECTIVE ROOTS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6383 BIRCH MEADOWS LN
FOWLERVILLE MI
48836-8610
US

IV. Provider business mailing address

6383 BIRCH MEADOWS LN
FOWLERVILLE MI
48836-8610
US

V. Phone/Fax

Practice location:
  • Phone: 517-304-5419
  • Fax:
Mailing address:
  • Phone: 517-304-5419
  • 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: AMANDA LYNN MARKLEY
Title or Position: LICENSED CLINCAL SOCIAL WORKER
Credential: LMSW
Phone: 517-375-8175