Leaf & Root Psychotherapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LEAF & ROOT PSYCHOTHERAPY, LLC

Practice address

66 N High St Apt a
Bridgton, ME 04009-1125

Phone

(207) 766-6538

NPI assigned

Nov 27, 2024

Organization subpart

No

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

Authorized official

Name

Chelsea Raven

Title

Owner

Phone

(207) 766-6538

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1942026554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 N HIGH ST APT A",
            "city": "BRIDGTON",
            "state": "ME",
            "postal_code": "040091125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 N HIGH ST APT A",
            "city": "BRIDGTON",
            "state": "ME",
            "postal_code": "040091125",
            "telephone_number": "207-766-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAF & ROOT PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "RAVEN",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-766-6538"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Bridgton, ME
• Providers in Bridgton, 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 Nov 27, 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.