=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881538031
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROOTED FOR GROWTH COUNSELING SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2026
-----------------------------------------------------
Last Update Date | 04/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 HIGHLAND AVE
-----------------------------------------------------
City | CARROLLTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41008-1016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-480-1096
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1985 HIGHWAY 467
-----------------------------------------------------
City | WORTHVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41098-9756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-480-1096
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KIMBERLY WATKINS
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 502-480-1096
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------