Active NPI
Strong Roots Therapeutic Services, LLC
- Clinical Social Worker
- Rudy, AR
National Provider Identifier
1215663554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- STRONG ROOTS THERAPEUTIC SERVICES, LLC
- Practice address
- 2429 Highway 348
Rudy, AR 72952-9401 - Phone
- (912) 674-0417
- NPI assigned
- Jul 28, 2022
- Last updated
- Jul 24, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tiffany Dawn Lemery, LCSW, CATP, CDC II,
- Title
- Ceo
- Phone
- (912) 674-0417
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
2429 Highway 348
Rudy, AR 72952-9401
Mailing address
PO Box 6155
Van Buren, AR 72956-0121
Phone (912) 674-0417
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1707635 | Medicaid | AK |
National Provider Directory
National Provider DirectoryLocations
851 E Westpoint Dr
Ste 210
Wasilla, AK 99654
Practitioners & affiliated clinicians
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.
-
- Clinical Social Worker
- Palmer, AK
- NPI 1639684749
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658966400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1784851200000",
"number": "1215663554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6155",
"city": "VAN BUREN",
"state": "AR",
"postal_code": "729560121",
"telephone_number": "912-674-0417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2429 HIGHWAY 348",
"city": "RUDY",
"state": "AR",
"postal_code": "729529401",
"telephone_number": "912-674-0417"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STRONG ROOTS THERAPEUTIC SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-07-28",
"last_updated": "2026-07-24",
"certification_date": "2026-07-24",
"status": "A",
"authorized_official_last_name": "LEMERY",
"authorized_official_first_name": "TIFFANY",
"authorized_official_middle_name": "DAWN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "912-674-0417",
"authorized_official_credential": "LCSW, CATP, CDC II,"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1707635",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rudy, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.