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General NPI Number Information
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NPI Number | 1093626988
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Entity Type | Organization
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Legal Business Name | ROOTED RELATIONSHIPS COUNSELING & RECOVERY, PLLC
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 104 WAXHAW PROFESSIONAL PARK DR STE D
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City | WAXHAW
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State | NC
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Zip | 28173-5020
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Country | US
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Telephone | 704-255-4708
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Fax | 704-255-4708
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Provider Business Mailing Address
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Address Line | 841 SPRING OAKS DR
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City | MATTHEWS
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State | NC
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Zip | 28104-5416
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Country | US
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Telephone | 704-400-1215
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | LISA A BIVENS
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Credential | LCMHCA, LCASA
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Telephone | 704-400-1215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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