Healthcare Provider Details
I. General information
NPI: 1326975996
Provider Name (Legal Business Name): ROOTED BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1951 BILLINGS HILL CHURCH RD
TRAPHILL NC
28685-9113
US
IV. Provider business mailing address
1951 BILLINGS HILL CHURCH RD
TRAPHILL NC
28685-9113
US
V. Phone/Fax
- Phone: 571-356-4214
- Fax:
- Phone: 571-356-4214
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JONATHAN
CLAUDE
WEEDON
II
Title or Position: OWNER/BCBA
Credential: M.S., LBA, BCBA
Phone: 571-356-4214