NPIMap

Organization Active NPI

Yakubov Life Therapy, PLLC

Doing business as Heal Your Roots Wellness

  • Marriage & Family Therapist
  • Bensalem, PA
National Provider Identifier
1063181964
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
YAKUBOV LIFE THERAPY, PLLC
Doing business as
Heal Your Roots Wellness
Practice address
2617 Street Rd # 282
Bensalem, PA 19020-2864
Phone
(484) 800-1652
NPI assigned
Sep 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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

Authorized official

Name
Kira Yakubov, LMFT
Title
Owner and Therapist
Phone
(484) 800-1652

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

2617 Street Rd # 282
Bensalem, PA 19020-2864

Mailing address

2617 Street Rd # 282
Bensalem, PA 19020-2864
Phone (484) 800-1652

Other names 1

  • Heal Your Roots Wellness Doing business as

National Provider Directory

National Provider Directory

Locations

2617 Street Rd
Bensalem, PA 19020
Phone (215) 690-1059

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662336000000",
    "number": "1063181964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 STREET RD # 282",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190202864",
            "telephone_number": "484-800-1652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 STREET RD # 282",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190202864",
            "telephone_number": "484-800-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAKUBOV LIFE THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-13",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A",
        "authorized_official_last_name": "YAKUBOV",
        "authorized_official_first_name": "KIRA",
        "authorized_official_title_or_position": "OWNER AND THERAPIST",
        "authorized_official_telephone_number": "484-800-1652",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heal Your Roots Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heal Your Roots Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bensalem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.