NPIMap

Organization Active NPI

Sacred Roots Wellness LLC

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1205724531
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SACRED ROOTS WELLNESS LLC
Practice address
43 E South St
Frederick, MD 21701-5617
Phone
(240) 367-9587
NPI assigned
Jun 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Authorized official

Name
Callie Rebecca Hildreth, LCSW-CNPI 1134636749
Title
Clinician
Phone
(240) 367-9587

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

43 E South St
Frederick, MD 21701-5617

Mailing address

43 E South St
Frederick, MD 21701-5617
Phone (240) 367-9587

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1750809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1205724531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 E SOUTH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015617",
            "telephone_number": "240-367-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 E SOUTH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015617",
            "telephone_number": "240-367-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED ROOTS WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "HILDRETH",
        "authorized_official_first_name": "CALLIE",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "240-367-9587",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.