| Rooted Counseling Llc | |
|
13242 S Route 59 Ste 102a Plainfield IL 60585-5438 | |
| (331) 465-9588 | |
| (331) 625-6448 |
| Full Name | Rooted Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13242 S Route 59 Ste 102a, Plainfield, Illinois |
| Authorized Official Name and Position | Jessica Parks (OWNER, CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6309355662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rooted Counseling Llc 221 Carol Ln Bolingbrook IL 60440-1694 Ph: (630) 935-5662 | Rooted Counseling Llc 13242 S Route 59 Ste 102a Plainfield IL 60585-5438 Ph: (331) 465-9588 |
| NPI Number | 1861007817 |
|---|---|
| Provider Enumeration Date | 09/15/2020 |
| Last Update Date | 12/17/2020 |
| Certification Date | 12/17/2020 |
| Medicare PECOS PAC ID | 5597175596 |
|---|---|
| Medicare Enrollment ID | O20201103001131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861007817 | NPI | - | NPPES |
| 149015311 | Other | IL | CLINICAL SOCIAL WORKER LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jessica A Parks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275812414 PECOS PAC ID: 6800041583 Enrollment ID: I20130301000506 |
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