ROOTS PSYCHIATRY & WELLNESS NPI 1841170842

NPI Information

  • NPI: 1841170842
  • Provider Name: ROOTS PSYCHIATRY & WELLNESS
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 4609 CHARLOTTE HWY STE 3
    LAKE WYLIE, SC
    ZIP 29710
  • Phone: (803) 373-2598

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NPI Details

ROOTS PSYCHIATRY & WELLNESS is a psychiatric/mental health nurse practitioner in Lake Wylie, SC. ROOTS PSYCHIATRY & WELLNESS NPI is 1841170842. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4609 CHARLOTTE HWY STE 3
LAKE WYLIE, SC
ZIP 29710-025
Phone: (803) 373-2598
Fax: (866) 884-5371

The provider's authorized official is Beth Wilson .
The authorized official title is Executive Director and has the following contact phone number (803) 675-8227.

The enumeration date for this NPI number is 9/3/2025 and was last updated on 9/3/2025.

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
1101YM0800XCounselorMental HealthNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

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: 11/21/2025

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