Healthcare Provider Details

I. General information

NPI: 1689587925
Provider Name (Legal Business Name): ROOTED PRESENCIA LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 US HIGHWAY 9 STE 5
WAPPINGERS FALLS NY
12590-4417
US

IV. Provider business mailing address

2522 SOUTH RD # 1019
POUGHKEEPSIE NY
12601-5468
US

V. Phone/Fax

Practice location:
  • Phone: 914-246-0324
  • Fax: 914-840-1182
Mailing address:
  • Phone: 917-513-8598
  • Fax: 914-840-1182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: GLENDALEE L MUNIZ
Title or Position: FOUNDING PROVIDER
Credential: LCSW
Phone: 917-513-8598