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General NPI Number Information
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NPI Number | 1881568780
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Entity Type | Organization
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Legal Business Name | ROOT AND RISE THERAPY
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 2302 NORTH KAWEAH AVE
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City | EXETOR
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State | CA
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Zip | 93221
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Country | US
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Telephone | 559-248-1868
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 6TH AVE STE 550 PMB 293188
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City | SAN DEIGO
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State | CA
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Zip | 92101
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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 | CEO
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Name | SKYYLR ATKINSON
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Credential | LCSW
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Telephone | 559-248-1868
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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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