| Rooted Therapy Services, Llc | |
|
1109 Roosevelt Rd Pella IA 50219-7965 | |
| (641) 780-0864 | |
| Not Available |
| Full Name | Rooted Therapy Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1109 Roosevelt Rd, Pella, Iowa |
| Authorized Official Name and Position | Julie Lynn Hooyer (SOCIAL WORKER) |
| Authorized Official Contact | 6417800864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rooted Therapy Services, Llc Po Box 687 Pella IA 50219-0687 Ph: (641) 780-0864 | Rooted Therapy Services, Llc 1109 Roosevelt Rd Pella IA 50219-7965 Ph: (641) 780-0864 |
| NPI Number | 1942910625 |
|---|---|
| Provider Enumeration Date | 12/02/2022 |
| Last Update Date | 12/02/2022 |
| Certification Date | 12/02/2022 |
| Medicare PECOS PAC ID | 9133599517 |
|---|---|
| Medicare Enrollment ID | O20221229000444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942910625 | NPI | - | NPPES |
| 1881930725 | Other | NPI 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Julie Lynn Hooyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881930725 PECOS PAC ID: 8921243163 Enrollment ID: I20130318000354 |
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