Provider Demographics
NPI:1598589715
Name:TAPROOTS HEALTH LLC
Entity type:Organization
Organization Name:TAPROOTS HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIDLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-641-6492
Mailing Address - Street 1:65 ROBINS ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-2558
Mailing Address - Country:US
Mailing Address - Phone:508-641-6492
Mailing Address - Fax:
Practice Address - Street 1:86 SPRING ST STE 1B
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-1789
Practice Address - Country:US
Practice Address - Phone:508-641-6492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty