NPIMap

Organization Active NPI

Roots Wellness Center, LLC

  • Professional Counselor
  • Kennesaw, GA
National Provider Identifier
1689167520
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC004570 Issued in GA
Legal business name
ROOTS WELLNESS CENTER, LLC
Practice address
3745 Cherokee St NW Ste 606
Kennesaw, GA 30144-6785
Phone
(404) 849-8230
NPI assigned
Jun 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Authorized official

Name
Amy Barker, LPCNPI 1710042866
Title
Owner
Phone
(404) 849-8230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X LPC004570 GA Primary

Addresses

Primary practice location

3745 Cherokee St NW Ste 606
Kennesaw, GA 30144-6785

Mailing address

4113 Hidden Enclave LN NW
Kennesaw, GA 30152-7781

National Provider Directory

National Provider Directory

Locations

3745 Cherokee St NW
Ste 606
Kennesaw, GA 30144
Phone (678) 656-7373

Practitioners & affiliated clinicians

Practitioners 6

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": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1689167520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 HIDDEN ENCLAVE LN NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 CHEROKEE ST NW STE 606",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446785",
            "telephone_number": "404-849-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-849-8230",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.