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General NPI Number Information
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NPI Number | 1245106491
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Entity Type | Organization
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Legal Business Name | ROOTED WILLOW WELLNESS LLC
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 63 NORWICH AVE STE 202
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City | COLCHESTER
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State | CT
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Zip | 06415-1242
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Country | US
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Telephone | 860-245-9649
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Fax |
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Provider Business Mailing Address
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Address Line | 67 LAKEVIEW HTS
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City | LEBANON
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State | CT
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Zip | 06249-2219
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Country | US
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Telephone | 860-681-7430
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Fax |
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Authorized Official
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Title or Position | OWNER & THERAPIST
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Name | SARAH GERRISH
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Credential | LPC
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Telephone | 860-681-7430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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