HEALING ROOTS COUNSELING LLC (NPI# 1902376163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902376163 |
| Entity Type | Organization |
| Organization Name | HEALING ROOTS COUNSELING LLC |
| Practice Address |
1690 Stone Village Ln Nw Ste 601b Kennesaw GA 30152-7777 |
| Mailing Address |
3773 Butterfield Dr Nw Kennesaw GA 30152-6989 |
| Practice Telephone | 6789485783 |
| Mailing Telephone | 6787707577 |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-11-30 |
| Authorized Official Name | KRISTINA TUCKER (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Telephone | 6789485783 |
| Authorized Official Credential | MA, LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
1690 STONE VILLAGE LN NW STE 601B |
| City | KENNESAW |
| State | GA |
| Zip Code | 30152-7777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143947 | Angie Fowler | Counselor | 1690 Stone Village Ln Nw Ste 601b, Kennesaw, GA 30152-7777 | 2020-01-20 |
| 1922578178 | Kristina Tucker | Counselor | 1690 Stone Village Ln Nw Ste 601b, Kennesaw, GA 30152-7777 | 2018-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821647124 | Ashley Dover | Nurse Practitioner | 1300 Ridenour Blvd, Suite 300, Kennesaw, GA 30152 | 2019-09-09 |
| 1205306891 | Lashanda Denise Moore | Nurse Practitioner | 1600 Kennesaw Due West Rd Nw #205, Kennesaw, GA 30152 | 2018-11-27 |
| 1265901094 | Focused Loving Home Care Services LLC | In Home Supportive Care | 2151 Marne Glen Nw, Kennesaw, GA 30152 | 2018-11-22 |
| 1083199152 | Raven Ashley Thomas | Behavioral Analyst | 1619 Collins Rd Nw Ste 500, Kennesaw, GA 30152 | 2018-09-25 |
| 1821592593 | Eseovhe Egborge PC | Clinic/Center | 1600 Kennesaw Due West Rd Nw Ste 205, Kennesaw, GA 30152 | 2018-03-19 |
| 1184143059 | Kennesaw Mountain Dental Associates | Dentist | 1815 Old 41 Hwy, Ste 310, Kennesaw, GA 30152 | 2017-09-12 |
| 1265955983 | Deborah Ruth Stern Compton | Registered Nurse | 1291 Stanley Rd., Kennesaw, GA 30152 | 2017-07-25 |
| 1912452939 | Mak Anesthesia Holdings LLC | Anesthesiology | 1300 Ridenour Blvd., Ste. 300, Kennesaw, GA 30152 | 2016-08-19 |
| 1528430279 | Tineka Nichol Wyckoff | Counselor | 1967 Lake Heights Circle, Kennesaw, GA 30152 | 2015-10-21 |
| 1669753992 | American Current Care Pa | Clinic/Center | 2953 Cobb Parkway, Suite 400, Kennesaw, GA 30152 | 2011-08-31 |
| Find all providers in zip 30152 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134635964 | Montana Keig | Counselor | 1750 Shiloh Rd Nw Apt 713, Kennesaw, GA 30144-6466 | 2017-12-15 |
| 1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
| 1922467414 | Jacqueline Oduselu | Counselor | 1827 Brackendale Rd Nw, Kennesaw, GA 30152-7747 | 2016-02-12 |
| 1801229141 | Latoya Kenner | Counselor | 3415 Old Highway 41 Ste 750, Kennesaw, GA 30144-1028 | 2013-08-09 |
| 1871845230 | Frances Burch-scott | Counselor | 4013 Cripple Creek Dr Nw, Kennesaw, GA 30144-2109 | 2012-10-10 |
| 1053636860 | Kimberly Marie Seheult | Counselor | 2055 Barrett Lakes Blvd, Apt 1402, Kennesaw, GA 30144 | 2010-04-05 |
| 1417271958 | Bailey Michael Cooper | Counselor | 4286 Windy Gap Ct Nw, Kennesaw, GA 30144-5121 | 2010-03-25 |
| 1801129424 | Latrisha Evon Mccauley, Dc | Counselor | 506 Pentworth Ct, Kennesaw, GA 30144 | 2009-09-15 |
| 1922246651 | Jean Marie Sanders | Counselor | 340 Bramford Way Nw, Kennesaw, GA 30144-1337 | 2009-02-03 |
| 1669623799 | J.d. Weidner | Counselor | 19 Latimer Ln Ne, Kennesaw, GA 30144-1593 | 2008-10-07 |
| Find all providers in KENNESAW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.