Healthcare Provider Details

I. General information

NPI: 1376459131
Provider Name (Legal Business Name): THE ROOTED PATH COLLABORATIVE, A PROGRAM OF NWR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1388 PRESIDENTIAL HWY
JEFFERSON NH
03583-6213
US

IV. Provider business mailing address

1388 PRESIDENTIAL HWY
JEFFERSON NH
03583-6213
US

V. Phone/Fax

Practice location:
  • Phone: 603-631-4847
  • Fax:
Mailing address:
  • Phone: 603-631-4847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VALARIE M TETREAULT
Title or Position: OWNER/PRACTITIONER
Credential: MAPP, NBC-HWC, CSC
Phone: 603-631-4847