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General NPI Number Information
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NPI Number | 1952272262
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Entity Type | Organization
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Legal Business Name | THRIVING ROOTS HAVEN INCORPORATED
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 1218 PEMBROOK LN
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City | CHATTANOOGA
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State | TN
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Zip | 37421-8811
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Country | US
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Telephone | 423-314-0083
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 PEMBROOK LN
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City | CHATTANOOGA
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State | TN
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Zip | 37421-8811
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Country | US
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Telephone | 423-314-0083
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | KEISHA MCWHOTER MCWHORTER
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Credential |
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Telephone | 423-314-0083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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