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General NPI Number Information
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NPI Number | 1770171233
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Entity Type | Organization
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Legal Business Name | ROOTED COUNSELING CENTER
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 01/08/2021
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Provider Practice Location Address
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Address Line | 4219 HILLSBORO PIKE STE 208
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City | NASHVILLE
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State | TN
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Zip | 37215-3326
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Country | US
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Telephone | 615-585-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 159151
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City | NASHVILLE
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State | TN
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Zip | 37215-9151
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ASHLEY COLCLASURE
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Credential |
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Telephone | 615-772-7979
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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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