Deeply Rooted Counseling & Wellness Center

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

DEEPLY ROOTED COUNSELING & WELLNESS CENTER

Practice address

2600 Ventura St Ste 110
Fresno, CA 93721-3041

Phone

(310) 654-9835

NPI assigned

Jun 12, 2023

Last updated

Jul 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shadaria R Prince, LCSWNPI 1669872578

Title

Licensed Clinical Social Worker

Phone

(310) 654-9835

Specialties & licenses 3

Addresses

Locations

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.

• Shadaria Rene Prince, LCSW

  • Clinical Social Worker
  • Fresno, CA
  • NPI 1669872578
  NPD Authorized official

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1871277764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4183 W WELDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937226893",
            "telephone_number": "310-654-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 VENTURA ST STE 110",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937213041",
            "telephone_number": "310-654-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEPLY ROOTED COUNSELING & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "SHADARIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "310-654-9835",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Declue
• Dedicated Care in-Home Services
• Prakash Chandra Deedwania, M.D.
• Shannon Marie Deen, RN
• Deep Feels Marriage and Family Therapy (Deep Feels Therapy)
• Deeply Rooted Family Counseling Prof Corp (Deeply Rooted Family Counseling)
• Emily Dees Goins
• Dajoine D Dees-Moore
• Valerie Defehr
• Brittany Marie Defendis, LCSW

• Adolescent and Children Mental Health Clinic/Center in Fresno, CA
• Providers in Fresno, CA by specialty
• Adolescent and Children Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.