Healthcare Provider Details

I. General information

NPI: 1407795693
Provider Name (Legal Business Name): ROOTED COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 W CANAL ST
PICAYUNE MS
39466-3951
US

IV. Provider business mailing address

316 THIRD AVE
PICAYUNE MS
39466-2554
US

V. Phone/Fax

Practice location:
  • Phone: 601-749-9477
  • Fax:
Mailing address:
  • Phone: 601-749-9477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LEAH BELL
Title or Position: OWNER
Credential:
Phone: 601-749-9477