Healthcare Provider Details

I. General information

NPI: 1255291373
Provider Name (Legal Business Name): ROOTS TO WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7B CORPORATE CENTER CT
GREENSBORO NC
27408-3839
US

IV. Provider business mailing address

701 GREEN VALLEY RD STE 100
GREENSBORO NC
27408-7096
US

V. Phone/Fax

Practice location:
  • Phone: 336-502-5107
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALANDRIA HUNTER
Title or Position: LCMHC,CCTP
Credential:
Phone: 336-502-5107