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General NPI Number Information
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NPI Number | 1073219507
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Entity Type | Organization
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Legal Business Name | ROOTED MENTAL HEALTH LLC
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 528 COTTAGE ST NE STE 401
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City | SALEM
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State | OR
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Zip | 97301-3861
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Country | US
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Telephone | 503-583-8537
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Fax | 503-343-3331
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Provider Business Mailing Address
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Address Line | 528 COTTAGE ST NE STE 401
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City | SALEM
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State | OR
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Zip | 97301-3861
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Country | US
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Telephone | 503-583-8537
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Fax | 503-343-3331
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH DELGROS-RYAN
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Credential | LCSW
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Telephone | 412-759-3919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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