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General NPI Number Information
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NPI Number | 1780529552
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Entity Type | Organization
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Legal Business Name | ROOTED LCSW SERVICES PLLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 1995 ROUTE 17M STE 2
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City | GOSHEN
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State | NY
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Zip | 10924-5240
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Country | US
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Telephone | 845-296-7965
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Fax |
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Provider Business Mailing Address
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Address Line | 114 W MAIN ST
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City | MIDDLETOWN
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State | NY
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Zip | 10940-4934
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Country | US
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Telephone | 845-296-7965
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EUNICE MARTINEZ SALAZAR
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Credential |
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Telephone | 845-296-7965
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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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