Provider Demographics
NPI:1104621085
Name:ROOTS AND REFLECTION COUNSELING LLC
Entity type:Organization
Organization Name:ROOTS AND REFLECTION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-529-8543
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:FLOYD
Mailing Address - State:VA
Mailing Address - Zip Code:24091-0013
Mailing Address - Country:US
Mailing Address - Phone:540-529-8543
Mailing Address - Fax:540-378-6044
Practice Address - Street 1:209 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FLOYD
Practice Address - State:VA
Practice Address - Zip Code:24091-3190
Practice Address - Country:US
Practice Address - Phone:540-529-8543
Practice Address - Fax:540-378-6044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty