NPIMap

Organization Active NPI

Roots Therapeutic Specialty Services

  • Clinical Social Worker
  • Zeeland, MI
National Provider Identifier
1861023756
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ROOTS THERAPEUTIC SPECIALTY SERVICES
Practice address
10263 Chicago Dr
Zeeland, MI 49464-1416
Phone
(616) 377-2283
NPI assigned
Jan 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Authorized official

Name
Diana Osipsov, LMSWNPI 1992055974
Title
Owner/Clinical Therapist
Phone
(616) 481-8919

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

10263 Chicago Dr
Zeeland, MI 49464-1416

Mailing address

10263 Chicago Dr
Zeeland, MI 49464-1416
Phone (616) 377-2283

Other identifiers 1

IdentifierTypeStateIssuer
13582106OtherCAQH

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL dosipsov@plantingdeeproots.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580256000000",
    "number": "1861023756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10263 CHICAGO DR",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494641416",
            "telephone_number": "616-377-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10263 CHICAGO DR",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494641416",
            "telephone_number": "616-377-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS THERAPEUTIC SPECIALTY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A",
        "authorized_official_last_name": "OSIPSOV",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OWNER/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "616-481-8919",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13582106",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "dosipsov@plantingdeeproots.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "address_1": "10263 Chicago Dr",
            "city": "Zeeland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494641416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Zeeland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.