Deep Roots Counseling Group LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

DEEP ROOTS COUNSELING GROUP LLC

Practice address

21 Blackstone St
Bellingham, MA 02019-1601

Phone

(774) 571-9069

NPI assigned

Jul 5, 2019

Organization subpart

No

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

Authorized official

Name

Kerrie Ann Cusack, LICSW

Title

Owner/Clinical Social Worker

Phone

(774) 571-9069

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567036800000",
    "number": "1093377418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BLACKSTONE ST",
            "city": "BELLINGHAM",
            "state": "MA",
            "postal_code": "020191601",
            "telephone_number": "774-571-9069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BLACKSTONE ST",
            "city": "BELLINGHAM",
            "state": "MA",
            "postal_code": "020191601",
            "telephone_number": "774-571-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP ROOTS COUNSELING GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-05",
        "last_updated": "2019-08-29",
        "status": "A",
        "authorized_official_last_name": "CUSACK",
        "authorized_official_first_name": "KERRIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "774-571-9069",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Laura Daly, PHARMD
• Priscilla Dankyi
• Judith Nicole Dayaw
• Katrina Isabel Dayaw, PSYD
• Robson Luiz De Luca
• Kari Marie Demoura, PA-C
• Halle Derouin, RDN, LDN
• Christine Amaral Detore, DPT
• Christopher Neal Devaney, PT
• Ida M Doetsch, BS

• All providers in Bellingham, MA
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.