Resilient Roots Therapy PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RESILIENT ROOTS THERAPY PLLC

Practice address

3600 S Water Tower PL
Mount Vernon, IL 62864-6589

Phone

(618) 244-0212

Fax

(618) 244-0535

NPI assigned

Nov 6, 2024

Organization subpart

No

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

Authorized official

Name

Melanie Downen, LCSWNPI 1679232607

Title

Owner/ Manager

Phone

(618) 244-0212

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Melanie Downen, LCSW

  • Clinical Social Worker
  • Mount Vernon, IL
  • NPI 1679232607
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1689497794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 S WATER TOWER PL",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646589",
            "telephone_number": "618-244-0212",
            "fax_number": "618-244-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 S WATER TOWER PL",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646589",
            "telephone_number": "618-244-0212",
            "fax_number": "618-244-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT ROOTS THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "DOWNEN",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "OWNER/ MANAGER",
        "authorized_official_telephone_number": "618-244-0212",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Christina Redden, MA, QMHP
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• Samantha Reynolds
• Lynn Rheinecker, PHARM.D., R.PH.
• Natasha Carol Rhodes, AGNP-C
• Amy Lynn Richards
• Lisa Riley, COTA/L

• Clinical Social Worker in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.