Healthcare Provider Details

I. General information

NPI: 1902711773
Provider Name (Legal Business Name): ROOTED HOPE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 PINE HAVEN SHORES RD STE 1000A
SHELBURNE VT
05482-7812
US

IV. Provider business mailing address

441 MAPLE ST APT A
BURLINGTON VT
05401-3924
US

V. Phone/Fax

Practice location:
  • Phone: 802-215-9915
  • Fax:
Mailing address:
  • Phone: 703-966-9375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ELIZABETH LEONARD
Title or Position: LICSW
Credential: LICSW
Phone: 703-966-9375