Rooted in Change, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ROOTED IN CHANGE, LLC

Practice address

422 W Spruce St Stop C
Missoula, MT 59802-4141

Phone

(858) 868-0364

NPI assigned

Dec 18, 2023

Last updated

Dec 18, 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

Dr. Angela Petersen, PH.D.NPI 1831547496

Title

Psychologist

Phone

(858) 868-0364

Specialties & licenses 1

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.

• Angela Petersen, PH.D.

  • Psychologist
  • La Jolla, CA
  • NPI 1831547496
  NPD Authorized official

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1912775065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16592",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598086592",
            "telephone_number": "858-868-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 W SPRUCE ST STOP C",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024141",
            "telephone_number": "858-868-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED IN CHANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "858-868-0364",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mette J. Romain, LCSW, LAC
• Anna Roman, MD
• Ronald F Rosser DDS PC
• Diane Roosa, PT
• Pat Roosa
• Roots and Wings Counseling Willow Tree Wellness LLC
• Roots Guidance and Counseling LLC
• Philip A. Roper, MD
• Samantha Rosaia, PA
• Rosauers Food and Drug #27

• Community/Behavioral Health Agency in Missoula, MT
• Providers in Missoula, MT by specialty
• Community/Behavioral Health Agency in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.