1083337802 NPI number — ROOTS TO LIMB COUNSELING PLLC

Table of content: (NPI 1083337802)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083337802 NPI number — ROOTS TO LIMB COUNSELING PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROOTS TO LIMB COUNSELING PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083337802
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
934 PAMLICO DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27511-3732
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-233-7558
Provider Business Mailing Address Fax Number:
919-234-7313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
206 HIGH HOUSE RD STE 108
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27513-8496
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-233-7558
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2022

Additional Information

Authorized Official

Authorized Official Last Name:
HALE
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/THERAPIST
Authorized Official Telephone Number:
910-233-7558

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: S7422 . This is a "THERAPIST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com