Organization Active NPI

Roots of Discovery LLC

Doing business as Roots of Discovery Counseling

  • Mental Health Counselor
  • St Augustine, FL
National Provider Identifier
1811704760
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ROOTS OF DISCOVERY LLC
Doing business as
Roots of Discovery Counseling
Practice address
260 Paseo Reyes Dr
St Augustine, FL 32095-8462
Phone
(904) 670-0709
NPI assigned
Dec 13, 2024
Last updated
Dec 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Authorized official

Name
Heather Brinker, LMHCNPI 1801581988
Title
Owner
Phone
(904) 710-2092

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
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

260 Paseo Reyes Dr
St Augustine, FL 32095-8462

Mailing address

211 Tarpon Bay CT
Ponte Vedra Beach, FL 32081-1501
Phone (904) 710-2092

Other names 1

  • Roots of Discovery Counseling Doing business as

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1811704760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 TARPON BAY CT",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320811501",
            "telephone_number": "904-710-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 PASEO REYES DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958462",
            "telephone_number": "904-670-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS OF DISCOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "BRINKER",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-710-2092",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roots of Discovery Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.