Healthcare Provider Details

I. General information

NPI: 1083337802
Provider Name (Legal Business Name): ROOTS TO LIMB COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 HIGH HOUSE RD STE 108
CARY NC
27513-8496
US

IV. Provider business mailing address

934 PAMLICO DR
CARY NC
27511-3732
US

V. Phone/Fax

Practice location:
  • Phone: 910-233-7558
  • Fax:
Mailing address:
  • Phone: 910-233-7558
  • Fax: 919-234-7313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER HALE
Title or Position: OWNER/THERAPIST
Credential: LMCHCS
Phone: 910-233-7558