MEDICARE: RESILIENT ROOTS COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1003761529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESILIENT ROOTS COUNSELING LLC

Provider Business Mailing Address
First Line	:	1724 CONIFER CT
Second Line	:
City	:	ARGYLE
State	:	TX
Zip	:	76226-3180
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3605 YUCCA DR STE 202
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-2753
Country	:	US
Telephone Number	:	682-593-1883
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MONIQUE VAN HOUTEN
Credential	:
Telephone Number	:	682-593-1883

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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