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General NPI Number Information
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NPI Number | 1740985688
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Entity Type | Organization
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Legal Business Name | ROOTED & RISING COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 03/31/2023
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Last Update Date | 04/01/2023
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Provider Practice Location Address
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Address Line | 556 NORAD DR
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City | BOX ELDER
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State | SD
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Zip | 57719-8114
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Country | US
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Telephone | 605-702-4731
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Fax |
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Provider Business Mailing Address
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Address Line | 3213 W MAIN ST # 123
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City | RAPID CITY
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State | SD
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Zip | 57702-2314
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Country | US
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Telephone | 605-702-4731
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | STEPHANIE BEARD
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Credential |
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Telephone | 605-702-4731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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