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General NPI Number Information
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NPI Number | 1992526347
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Entity Type | Organization
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Legal Business Name | HEALING FROM THE ROOTS PLLC
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 4620 CEDAR AVE STE 117
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City | WILMINGTON
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State | NC
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Zip | 28403-4423
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Country | US
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Telephone | 910-632-0651
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Fax | 910-556-5900
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Provider Business Mailing Address
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Address Line | 1425 PARKLAND WAY
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City | LELAND
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State | NC
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Zip | 28451-9353
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Country | US
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Telephone | 910-632-0651
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Fax | 910-556-5900
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH WESTMORELAND
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Credential | LCSW
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Telephone | 910-632-0651
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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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