NPI Code Details Logo

NPI 1306709209

NPI 1306709209 : ROOTED WITHIN COUNSELING LLC : LIBERTY, MO

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1306709209
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ROOTED WITHIN COUNSELING LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/08/2025
-----------------------------------------------------
    Last Update Date     |    12/08/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    214 E KANSAS ST STE 102 
-----------------------------------------------------
    City                 |    LIBERTY
-----------------------------------------------------
    State                |    MO
-----------------------------------------------------
    Zip                  |    64068-2355
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    816-200-0366
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    214 E KANSAS ST STE 102 
-----------------------------------------------------
    City                 |    LIBERTY
-----------------------------------------------------
    State                |    MO
-----------------------------------------------------
    Zip                  |    64068-2355
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    816-200-0366
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    LICENSED PROFESSIONAL COUNSELOR
-----------------------------------------------------
    Name                 |    MS. HEATHER RYAN HAWKINS 
-----------------------------------------------------
    Credential           |    LPC
-----------------------------------------------------
    Telephone            |    816-200-0366
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QM0801X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.