Organization Active NPI

Strong Roots Therapeutic Services, LLC

  • Clinical Social Worker
  • Rudy, AR
National Provider Identifier
1215663554
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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,NPI 1639684749
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1707635MedicaidAK

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.