Rooted Willow Therapy

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ROOTED WILLOW THERAPY

Practice address

330B S University Ave
Mount Pleasant, MI 48858-2525

Phone

(989) 331-0045

NPI assigned

Sep 14, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shelby Cristine Carson, LPC

Title

Owner and Therapist

Phone

(989) 331-0045

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1023730314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330B S UNIVERSITY AVE",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488582525",
            "telephone_number": "899-331-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330B S UNIVERSITY AVE",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488582525",
            "telephone_number": "989-331-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED WILLOW THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-14",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_middle_name": "CRISTINE",
        "authorized_official_title_or_position": "OWNER AND THERAPIST",
        "authorized_official_telephone_number": "989-331-0045",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811460751",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rootedwillowtherapy@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "address_1": "330B S University Ave",
            "city": "Mount Pleasant",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488582525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Behavioral Health Agency in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.