| Inner Roots Behavioral Health Pllc | |
|
123 N Main St Ste 107 Loretto TN 38469-2356 | |
| (931) 223-6659 | |
| Not Available |
| Full Name | Inner Roots Behavioral Health Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 123 N Main St Ste 107, Loretto, Tennessee |
| Authorized Official Name and Position | Nikki Lee Davenport (OWNER & MANAGING MEMBER) |
| Authorized Official Contact | 9312429298 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Roots Behavioral Health Pllc 123 N Main St Ste 107 Loretto TN 38469-2356 Ph: (931) 223-6659 | Inner Roots Behavioral Health Pllc 123 N Main St Ste 107 Loretto TN 38469-2356 Ph: (931) 223-6659 |
| NPI Number | 1437027976 |
|---|---|
| Provider Enumeration Date | 10/27/2025 |
| Last Update Date | 03/10/2026 |
| Certification Date | 03/10/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437027976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |