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General NPI Number Information
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NPI Number | 1871412429
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Entity Type | Organization
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Legal Business Name | ROOTS AND WONDER COUNSELING PLLC
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Dates
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Enumeration Date | 07/15/2026
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | 4101 W HUNTINGTON DR APT 5111
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City | ROGERS
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State | AR
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Zip | 72758
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Country | US
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Telephone | 870-847-0867
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Fax |
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Provider Business Mailing Address
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Address Line | 4021 W WALNUT ST # 1034
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City | ROGERS
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State | AR
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Zip | 72756-1842
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Country | US
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Telephone | 870-847-0867
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTY GOODWIN
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Credential | LPC
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Telephone | 870-847-0867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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