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General NPI Number Information
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NPI Number | 1932066198
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Entity Type | Organization
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Legal Business Name | ROOTS OF A WILLOW COUNSELING, LLC
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 1455 BARTERBROOK RD
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City | STAUNTON
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State | VA
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Zip | 24401-5560
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Country | US
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Telephone | 540-324-8829
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 BARTERBROOK RD
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City | STAUNTON
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State | VA
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Zip | 24401-5560
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Country | US
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Telephone | 540-324-8829
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRYSTLE LANDES
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Credential | LPC
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Telephone | 540-324-8829
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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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