FRESH ROOTS INC. NPI 1053479634

NPI Information

NPI: 1053479634
Provider Name: FRESH ROOTS, INC.

Doing Business As: FRESH ROOTS FAMILY COUNSELING

Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
318 W POPLAR ST
ROGERS, AR
ZIP 72756
Phone: (479) 986-8655
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FRESH ROOTS, INC. is a professional counselor in Rogers, AR. FRESH ROOTS, INC. NPI is 1053479634. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Fresh Roots Family Counseling.

The provider's business location address is:

318 W POPLAR ST
ROGERS, AR
ZIP 72756-559
Phone: (479) 986-8655
Fax: (479) 633-9398

The provider's authorized official is Dell Christy Tyson .
The authorized official title is Co-director and has the following contact phone number (479) 986-8655.

The enumeration date for this NPI number is 12/5/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	P9201002	ARKANSAS	Yes
2	106H00000X	Marriage & Family Therapist		M9710002	ARKANSAS	X

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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