MEDICARE: NURTURED ROOTS COUNSELING AND CONSULTING, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor
3	106H00000X	Marriage & Family Therapist
4	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1194661884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURTURED ROOTS COUNSELING AND CONSULTING, LLC

Provider Business Mailing Address
First Line	:	3425 N KOSTNER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-3806
Country	:	US
Telephone Number	:	920-988-7549
Fax Number	:

Provider Business Practice Location Address
First Line	:	4327 W IRVING PARK RD STE 2A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2826
Country	:	US
Telephone Number	:	920-988-7549
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST/OWNER
Name	:	MS. AMANDA JONES-FISCHER
Credential	:	LCSW
Telephone Number	:	920-988-7549

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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