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General NPI Number Information
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NPI Number | 1174073480
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Entity Type | Organization
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Legal Business Name | ROOTED IN LOVE COUNSELING SERVICES
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 3397 WINDLAND DR
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City | FLINT
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State | MI
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Zip | 48504-1764
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Country | US
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Telephone | 810-399-6603
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Fax |
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Provider Business Mailing Address
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Address Line | 1308 RAE ST
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City | MOUNT MORRIS
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State | MI
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Zip | 48458-1751
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Country | US
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Telephone | 810-399-6603
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | SAMANTHA RENEE PILLOW
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Credential | LLPC, CAADC
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Telephone | 810-399-6603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401014779
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License Number State | MI
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