| Rooted Therapeutic Healing | |
|
5800 Monroe St Ste A9 Sylvania OH 43560-2208 | |
| (419) 318-3818 | |
| (877) 927-2984 |
| Full Name | Rooted Therapeutic Healing |
|---|---|
| Speciality | Social Worker |
| Location | 5800 Monroe St Ste A9, Sylvania, Ohio |
| Authorized Official Name and Position | Ashley Nichole Thielman (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4194810806 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rooted Therapeutic Healing 25940 W River Rd Perrysburg OH 43551-9786 Ph: (419) 481-0806 | Rooted Therapeutic Healing 5800 Monroe St Ste A9 Sylvania OH 43560-2208 Ph: (419) 318-3818 |
| NPI Number | 1407536436 |
|---|---|
| Provider Enumeration Date | 07/24/2023 |
| Last Update Date | 08/12/2024 |
| Certification Date | 08/12/2024 |
| Medicare PECOS PAC ID | 0840645081 |
|---|---|
| Medicare Enrollment ID | O20231009001875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407536436 | NPI | - | NPPES |
| 0022954 | Medicaid | OH | |
| 0221379 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ashley Nichole Thielman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235607300 PECOS PAC ID: 3779955497 Enrollment ID: I20230207000481 |
| Provider Name | Riann Tippett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104333186 PECOS PAC ID: 5193197804 Enrollment ID: I20231108003555 |
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