NPIMap

Organization Active NPI

Rooted Relational Therapy LLC

  • Marriage & Family Therapist
  • Mifflinburg, PA
National Provider Identifier
1073096780
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
ROOTED RELATIONAL THERAPY LLC
Practice address
400 Market St
Mifflinburg, PA 17844-1249
Phone
(570) 884-4662
NPI assigned
Sep 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Authorized official

Name
Doug Richard, MAMFTNPI 1144703851
Title
Owner and Therapist
Phone
(570) 884-4662

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

400 Market St
Mifflinburg, PA 17844-1249

Mailing address

PO Box 54
Mifflinburg, PA 17844-0054
Phone (570) 884-4662

Other names 1

  • Rooted Relational Therapy Other name

National Provider Directory

National Provider Directory

Locations

434 Chestnut St
Mifflinburg, PA 17844
Phone (570) 884-4662

Practitioners & affiliated clinicians

Practitioners 6

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": "1536451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537228800000",
    "number": "1073096780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54",
            "city": "MIFFLINBURG",
            "state": "PA",
            "postal_code": "178440054",
            "telephone_number": "570-884-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MARKET ST",
            "city": "MIFFLINBURG",
            "state": "PA",
            "postal_code": "178441249",
            "telephone_number": "570-884-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED RELATIONAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-09",
        "last_updated": "2018-09-18",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "OWNER AND THERAPIST",
        "authorized_official_telephone_number": "570-884-4662",
        "authorized_official_credential": "MAMFT"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rooted Relational Therapy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Rooted Relational Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mifflinburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.