Rooted Therapeutic Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ROOTED THERAPEUTIC CENTER

Practice address

20312 Grazing Way
Montgomery Village, MD 20886-1210

Phone

(240) 644-7534

NPI assigned

May 12, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Manuela E. Mbouma, LCPCNPI 1851941256

Title

Founder/Therapist

Phone

(240) 644-7534

Specialties & licenses 1

Addresses

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.

• Manuela Mbouma, LGPC

  • Professional Counselor
  • District Heights, MD
  • NPI 1851941256
  NPD Authorized official

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1184208407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20312 GRAZING WAY",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208861210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20312 GRAZING WAY",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208861210",
            "telephone_number": "240-644-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED THERAPEUTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "MBOUMA",
        "authorized_official_first_name": "MANUELA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "FOUNDER/THERAPIST",
        "authorized_official_telephone_number": "240-644-7534",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revive Counseling Services, LLC
• Reeshemah R Robinson
• Candelaria Rodelo, CNA
• Therese Marie Rodriguez, R.N. C.F.C.P
• Ronna Keagle & Associates LLC
• Jennifer Rorie
• Joseph Mark Rosenwald, DDS
• Marc Neil Rubinstein, D.D.S.
• Ryan Rehabilitation LLC (Ryan Rehabilitation)
• Ryan Rehabilitation LLC

• Mental Health Counselor in Montgomery Village, MD
• Providers in Montgomery Village, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.