NPIMap

Organization Active NPI

Resilient Roots Therapy Center, LLC

  • Mental Health Counselor
  • Dunwoody, GA
National Provider Identifier
1881422798
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RESILIENT ROOTS THERAPY CENTER, LLC
Practice address
4484 Pineridge Cir
Dunwoody, GA 30338-6540
Phone
(248) 756-4004
NPI assigned
Jul 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Dr. Erin Lisa KaufmanNPI 1457940926
Title
Ceo
Phone
(248) 756-4004

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Recovery Care Clinic/Center 261QR0800X

Addresses

Primary practice location

4484 Pineridge Cir
Dunwoody, GA 30338-6540

Mailing address

4484 Pineridge Cir
Dunwoody, GA 30338-6540
Phone (248) 756-4004

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": "1721692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1881422798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4484 PINERIDGE CIR",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303386540",
            "telephone_number": "248-756-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4484 PINERIDGE CIR",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303386540",
            "telephone_number": "248-756-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT ROOTS THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "KAUFMAN",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-756-4004",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.