Healthcare Provider Details

I. General information

NPI: 1437066818
Provider Name (Legal Business Name): RESILIENT ROOTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W UNIVERSITY DR STE 6
ROCHESTER MI
48307-1975
US

IV. Provider business mailing address

4780 CIDER HILL DR
ROCHESTER MI
48306-1607
US

V. Phone/Fax

Practice location:
  • Phone: 623-760-2020
  • Fax:
Mailing address:
  • Phone: 623-760-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: NATALIE ELIZABETH PRILL IRVINE
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LPC
Phone: 623-760-2020