Healthcare Provider Details

I. General information

NPI: 1033039169
Provider Name (Legal Business Name): RESILIENT ROOTS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 GRIGGS DR
PRINCETON NJ
08540-7728
US

IV. Provider business mailing address

278 GRIGGS DR
PRINCETON NJ
08540-7728
US

V. Phone/Fax

Practice location:
  • Phone: 609-227-8049
  • Fax:
Mailing address:
  • Phone: 609-227-8049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JELANI MCMATH
Title or Position: OWNER
Credential: M. ED, LPC
Phone: 609-227-8049