NPIMap

Organization Active NPI

Deeply Rooted Family Counseling Prof Corp

  • Mental Health Counselor
  • Fresno, CA
National Provider Identifier
1104697499
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DEEPLY ROOTED FAMILY COUNSELING PROF CORP
Practice address
5740 N Palm Ave Ste 101
Fresno, CA 93704-1800
Phone
(559) 283-5441
NPI assigned
Jan 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Authorized official

Name
Jackson Spencer, LMFTNPI 1831590884
Title
President/Clinician
Phone
(559) 283-5441

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

5740 N Palm Ave Ste 101
Fresno, CA 93704-1800

Mailing address

5740 N Palm Ave Ste 101
Fresno, CA 93704-1800
Phone (559) 547-0907

Other practice location 1

5740 N Palm Ave Ste 111
Fresno, CA 93704-1800
Phone (559) 547-0907

Other names 1

  • Deeply Rooted Family Counseling Doing business as

National Provider Directory

National Provider Directory

Locations

5740 N Palm Ave
Ste 101
Fresno, CA 93704
Phone (559) 513-9521

Practitioners & affiliated clinicians

Practitioners 11

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": "1705276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1104697499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5740 N PALM AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937041800",
            "telephone_number": "559-547-0907",
            "fax_number": "559-705-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 N PALM AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937041800",
            "telephone_number": "559-283-5441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5740 N Palm Ave Ste 111",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937041800",
            "country_code": "US",
            "telephone_number": "559-547-0907",
            "fax_number": "559-705-1921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DEEPLY ROOTED FAMILY COUNSELING PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-15",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_title_or_position": "PRESIDENT/CLINICIAN",
        "authorized_official_telephone_number": "559-283-5441",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deeply Rooted Family Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.