=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811795479
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE ROOTED PATH THERAPY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2025
-----------------------------------------------------
Last Update Date | 03/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 402 HILLCREEK DR
-----------------------------------------------------
City | WHITEHOUSE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75791-3330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-724-1703
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 402 HILLCREEK DR
-----------------------------------------------------
City | WHITEHOUSE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75791-3330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-724-1703
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER & THERAPIST
-----------------------------------------------------
Name | ASHLEY LEMON
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 903-724-1703
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------