| Roots Unraveled, Llc | |
|
413 Neponset Ave Ste 1 Dorchester MA 02122-3184 | |
| (617) 539-6339 | |
| Not Available |
| Full Name | Roots Unraveled, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 413 Neponset Ave Ste 1, Dorchester, Massachusetts |
| Authorized Official Name and Position | Jasmine Welcome (CLINICIAN/OWNER) |
| Authorized Official Contact | 6178203566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots Unraveled, Llc 413 Neponset Ave Ste 1 Dorchester MA 02122-3184 Ph: (617) 539-6339 | Roots Unraveled, Llc 413 Neponset Ave Ste 1 Dorchester MA 02122-3184 Ph: (617) 539-6339 |
| NPI Number | 1316540743 |
|---|---|
| Provider Enumeration Date | 11/18/2020 |
| Last Update Date | 11/18/2020 |
| Certification Date | 11/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316540743 | NPI | - | NPPES |
| 1457888737 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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