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General NPI Number Information
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NPI Number | 1154130292
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Entity Type | Organization
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Legal Business Name | ROOTS & HORIZONS, LLC
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 82 WENDELL AVE STE 100
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City | PITTSFIELD
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State | MA
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Zip | 01201-7066
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Country | US
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Telephone | 857-244-1864
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Fax |
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Provider Business Mailing Address
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Address Line | 11 APEX DRIVE SUITE 300A #133
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City | MARLBOROUGH
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State | MA
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Zip | 01752
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Country | US
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Telephone | 857-244-1864
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIELLE BLAIS
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Credential | MA
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Telephone | 857-244-1864
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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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