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General NPI Number Information
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NPI Number | 1922921808
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Entity Type | Organization
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Legal Business Name | ROOTED MIND & BODY WELLNESS
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 113 MAIN ST STE 302-C
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City | OSWEGO
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State | IL
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Zip | 60543-1264
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Country | US
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Telephone | 847-452-6025
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Fax |
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Provider Business Mailing Address
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Address Line | 110 DORSET AVE
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City | OSWEGO
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State | IL
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Zip | 60543-6054
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Country | US
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Telephone | 847-452-6025
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA LAMORTE
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Credential | LCSW, CYT-200
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Telephone | 847-452-6025
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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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