| Well Rooted Life Llc | |
|
6424 E Greenway Pkwy Ste 145 Scottsdale AZ 85254-2045 | |
| (602) 833-2019 | |
| Not Available |
| Full Name | Well Rooted Life Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6424 E Greenway Pkwy Ste 145, Scottsdale, Arizona |
| Authorized Official Name and Position | Kirsten Powell (CEO) |
| Authorized Official Contact | 6028332019 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Well Rooted Life Llc 6424 E Greenway Pkwy Ste 145 Scottsdale AZ 85254-2045 Ph: (602) 833-2019 | Well Rooted Life Llc 6424 E Greenway Pkwy Ste 145 Scottsdale AZ 85254-2045 Ph: (602) 833-2019 |
| NPI Number | 1245727650 |
|---|---|
| Provider Enumeration Date | 04/20/2018 |
| Last Update Date | 10/09/2018 |
| Medicare PECOS PAC ID | 3274887161 |
|---|---|
| Medicare Enrollment ID | O20181112002641 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245727650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kirsten A Powell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003350844 PECOS PAC ID: 0648554121 Enrollment ID: I20170228002442 |
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