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General NPI Number Information
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NPI Number | 1548053200
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Entity Type | Organization
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Legal Business Name | NURTURED ROOTS COUNSELING LCSW PLLC
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 200 TRILLIUM LN
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City | ALBANY
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State | NY
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Zip | 12203-3818
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Country | US
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Telephone | 518-217-8690
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Fax |
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Provider Business Mailing Address
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Address Line | 11 PIKE ST
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City | HOOSICK FALLS
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State | NY
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Zip | 12090-4423
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Country | US
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Telephone | 518-217-8690
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSIE F MUNOZ
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Credential | LCSW
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Telephone | 518-217-8690
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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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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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