Organization Active NPI

Roots and Wings Connections Family Counseling

  • Mental Health Counselor
  • Chesapeake, VA
National Provider Identifier
1255098232
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ROOTS AND WINGS CONNECTIONS FAMILY COUNSELING
Practice address
1452 Kemp Bridge Drive
Chesapeake, VA 23320
Phone
(757) 876-5063
NPI assigned
Nov 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Authorized official

Name
Kim Richardson
Title
Credentialing
Phone
(757) 907-2567

Specialties & licenses 1

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

Addresses

Primary practice location

1452 Kemp Bridge Drive
Chesapeake, VA 23320

Mailing address

1452 Kemp Bridge Dr
Chesapeake, VA 23320-5057
Phone (757) 876-8321

Other identifiers 1

IdentifierTypeStateIssuer
0701010410OtherVALICENSE

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": "1637712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637712000000",
    "number": "1255098232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 KEMP BRIDGE DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205057",
            "telephone_number": "757-876-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1452 KEMP BRIDGE DRIVE",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23320",
            "telephone_number": "757-876-5063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS AND WINGS CONNECTIONS FAMILY COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "757-907-2567"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0701010410",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.