Organization Active NPI

Roots Psychiatry & Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Wylie, SC
National Provider Identifier
1841170842
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ROOTS PSYCHIATRY & WELLNESS
Practice address
4609 Charlotte Hwy Ste 3
Lake Wylie, SC 29710-8025
Phone
(803) 373-2598
Fax
(866) 884-5371
NPI assigned
Sep 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Authorized official

Name
Dr. Beth Wilson, PHD, LPCS, LCMHCSNPI 1407993728
Title
Executive Director
Phone
(803) 675-8227

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4609 Charlotte Hwy Ste 3
Lake Wylie, SC 29710-8025

Mailing address

4609 Charlotte Hwy Ste 3
Lake Wylie, SC 29710-8025
Phone (803) 373-2598

National Provider Directory

National Provider Directory

Locations

4609 Charlotte Hwy
Ste 3
Lake Wylie, SC 29710
Phone (803) 373-2598

Practitioners & affiliated clinicians

Practitioners 1

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": "1756857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1841170842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 CHARLOTTE HWY STE 3",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297108025",
            "telephone_number": "803-373-2598",
            "fax_number": "866-884-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 CHARLOTTE HWY STE 3",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297108025",
            "telephone_number": "803-373-2598",
            "fax_number": "866-884-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS PSYCHIATRY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "803-675-8227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LPCS, LCMHCS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wylie, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.