Resilient Roots Therapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RESILIENT ROOTS THERAPY

Practice address

744 Roosevelt TRL Ste 207
Windham, ME 04062-5281

Phone

(207) 550-1043

NPI assigned

Jan 10, 2025

Organization subpart

No

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

Authorized official

Name

San Pao, LCSW

Title

Owner/LCSW

Phone

(207) 550-1043

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1736467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1891505939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 ROOSEVELT TRL STE 207",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 ROOSEVELT TRL STE 207",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625281",
            "telephone_number": "207-550-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT ROOTS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "PAO",
        "authorized_official_first_name": "SAN",
        "authorized_official_title_or_position": "OWNER/LCSW",
        "authorized_official_telephone_number": "207-550-1043",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher S Pribish
• Lynn Priest, LMT
• Virginia Purcell, LMT
• Siobhan Marie Raymond, MASSAGE THERAPIST
• Dana C. Reed, D.MIN.
• Restorative Wellness
• Stella Catherine Rich, LADC
• Richard Intiso D.M.D., PA
• Right2Health
• Sonia Katherine Righter, FNP-BC

• Clinical Social Worker in Windham, ME
• Providers in Windham, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.