| Root Counseling Growth & Development For Adults, Adoles & Child, Llc | |
|
500 W Wilson Bridge Rd Ste 75 Worthington OH 43085-2238 | |
| (614) 395-9183 | |
| Not Available |
| Full Name | Root Counseling Growth & Development For Adults, Adoles & Child, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 500 W Wilson Bridge Rd Ste 75, Worthington, Ohio |
| Authorized Official Name and Position | Avalon Bultema Espinoza (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6143959183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Root Counseling Growth & Development For Adults, Adoles & Child, Llc 500 W Wilson Bridge Rd Ste 75 Worthington OH 43085-2238 Ph: (614) 395-9183 | Root Counseling Growth & Development For Adults, Adoles & Child, Llc 500 W Wilson Bridge Rd Ste 75 Worthington OH 43085-2238 Ph: (614) 395-9183 |
| NPI Number | 1770230179 |
|---|---|
| Provider Enumeration Date | 03/05/2022 |
| Last Update Date | 03/05/2022 |
| Certification Date | 02/28/2022 |
| Medicare PECOS PAC ID | 2163809872 |
|---|---|
| Medicare Enrollment ID | O20220519000313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770230179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Avalon Espinoza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033590641 PECOS PAC ID: 5890172506 Enrollment ID: I20220519000627 |
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