Grounded Roots Therapy PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GROUNDED ROOTS THERAPY PLLC

Practice address

11845 Guildhall LN
Charlotte, NC 28213-3890

Phone

(336) 965-8641

NPI assigned

Jun 21, 2021

Organization subpart

No

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

Authorized official

Name

Dominique Edouard, MSW, LCSWNPI 1497249130

Title

Member/Organizer

Phone

(336) 965-8641

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.

• Dominique Rachael Edouard, LCSW-A

  • Clinical Social Worker
  • Gastonia, NC
  • NPI 1497249130
  NPD Authorized official

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1316516784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11845 GUILDHALL LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282133890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11845 GUILDHALL LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282133890",
            "telephone_number": "336-965-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUNDED ROOTS THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "EDOUARD",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "MEMBER/ORGANIZER",
        "authorized_official_telephone_number": "336-965-8641",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Maria Grosso, DO
• Julia Grote, DO
• Kira Rose Grotevant, STUDENT AT
• Gina Menzo Grothoff, OTR/L
• Grounded Roots Psychotherapy Services PLLC
• Grounded Worth Therapy, PLLC
• Groundwater Solutions, Inc.
• Danielle Janice Grouse
• Grove Counseling
• Grover Clinic P.C.

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.