Healthcare Provider Details

I. General information

NPI: 1306709209
Provider Name (Legal Business Name): ROOTED WITHIN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 E KANSAS ST STE 102
LIBERTY MO
64068-2355
US

IV. Provider business mailing address

214 E KANSAS ST STE 102
LIBERTY MO
64068-2355
US

V. Phone/Fax

Practice location:
  • Phone: 816-200-0366
  • Fax:
Mailing address:
  • Phone: 816-200-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. HEATHER RYAN HAWKINS
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 816-200-0366