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General NPI Number Information
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NPI Number | 1700664349
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Entity Type | Organization
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Legal Business Name | DEEPLY ROOTED COUNSELING LLC
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 7112 W JEFFERSON AVE STE 307
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City | LAKEWOOD
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State | CO
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Zip | 80235-2328
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Country | US
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Telephone | 720-445-6274
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Fax |
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Provider Business Mailing Address
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Address Line | 6442 S HOLLAND CT
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City | LITTLETON
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State | CO
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Zip | 80123-3167
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Country | US
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Telephone | 308-258-0847
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Fax |
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Authorized Official
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Title or Position | OWNER AND THERAPIST
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Name | KENNA BRAUCHLER
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Credential | LCSW
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Telephone | 308-258-0847
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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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