| Profound Roots Therapy Services | |
|
609 Lisa Road West Dundee IL 60118 | |
| (847) 565-1084 | |
| (847) 787-1746 |
| Full Name | Profound Roots Therapy Services |
|---|---|
| Speciality | Counselor - Professional |
| Location | 609 Lisa Road, West Dundee, Illinois |
| Authorized Official Name and Position | Nelicia Butler (OWNER) |
| Authorized Official Contact | 8475651084 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Profound Roots Therapy Services 244 S Randall Rd Ste 1134 Elgin IL 60123-5529 Ph: (847) 565-1084 | Profound Roots Therapy Services 609 Lisa Road West Dundee IL 60118 Ph: (847) 565-1084 |
| NPI Number | 1487348728 |
|---|---|
| Provider Enumeration Date | 06/08/2023 |
| Last Update Date | 06/08/2023 |
| Certification Date | 05/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487348728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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