Wildly Rooted Counseling LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

WILDLY ROOTED COUNSELING LLC

Practice address

304 W Spotswood Trail
Suite D
Elkton, VA 22827

Phone

(540) 578-3691

Fax

(540) 578-3691

NPI assigned

Mar 23, 2022

Last updated

Mar 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kate A Bowman, MA, LPCNPI 1124774088

Title

Owner

Phone

(540) 578-3691

Specialties & licenses 1

Addresses

Other names 1

• Wildly Rooted Counseling LLC Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kate A Bowman

  • Professional Counselor
  • Elkton, VA
  • NPI 1124774088
  NPD Authorized official

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1104575430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W SPOTSWOOD TRAIL",
            "address_2": "SUITE D",
            "city": "ELKTON",
            "state": "VA",
            "postal_code": "22827",
            "telephone_number": "540-578-3691",
            "fax_number": "540-578-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W SPOTSWOOD TRAIL",
            "address_2": "SUITE D",
            "city": "ELKTON",
            "state": "VA",
            "postal_code": "22827",
            "telephone_number": "540-578-3691",
            "fax_number": "540-578-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDLY ROOTED COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "KATE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-578-3691",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wildly Rooted Counseling LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Donna Carole Thacker, NP-C
• John W. Timmons, MD
• Janice Lorene Usnick, DMD
• Molly R Van Horn, PA
• Walgreen Co (Walgreens #17535)
• Stacie Wood, DPT

• Professional Counselor in Elkton, VA
• Providers in Elkton, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.