Roots Renewal Counseling, Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ROOTS RENEWAL COUNSELING, INC

Practice address

61396 S Hwy 97 Ste 230
Bend, OR 97702-2558

Phone

(314) 200-5594

NPI assigned

Oct 25, 2021

Organization subpart

No

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

Authorized official

Name

Stephanie Stockham-Ronollo, MA, LPC, RPT, NCCNPI 1215307525

Title

Director

Phone

(314) 200-5594

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Stockham-Ronollo, LIMPH

  • Counselor
  • Omaha, NE
  • NPI 1215307525

  OR

  Medicare reassignment NPD Authorized official
• Naomi Passarelli

  • Mental Health Counselor
  • Bend, OR
  • NPI 1538874870
  NPD
• Sally A Crowe, LCSW

  • Clinical Social Worker
  • Bend, OR
  • NPI 1366619603

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1336803451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61396 S HWY 97 STE 230",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022558",
            "telephone_number": "314-200-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61396 S HWY 97 STE 230",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022558",
            "telephone_number": "314-200-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS RENEWAL COUNSELING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "STOCKHAM-RONOLLO",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-200-5594",
        "authorized_official_credential": "MA, LPC, RPT, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Jean Rood, CHW
• Sacha V Rood, LCSW
• Timothy Mark Roos, MD
• Roots and Branches Counseling LLC
• Roots Family Medicine LLC
• Ken Roper
• Ana Rosabal
• Natalie Rose
• Aimee Roseborrough, PT
• Roseman Clinic for Chinese Medicine Inc.

• Mental Health Counselor in Bend, OR
• Providers in Bend, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.