| Root & Bloom Therapy Pllc | |
|
1955 W Hamlin Rd Ste 101 Rochester Hills MI 48309-3338 | |
| (810) 618-4374 | |
| Not Available |
| Full Name | Root & Bloom Therapy Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1955 W Hamlin Rd Ste 101, Rochester Hills, Michigan |
| Authorized Official Name and Position | Jordan Riley Tasker (CO-OWNER/COUNSELOR) |
| Authorized Official Contact | 8106184374 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Root & Bloom Therapy Pllc 1955 W Hamlin Rd Ste 101 Rochester Hills MI 48309-3338 Ph: (248) 301-6455 | Root & Bloom Therapy Pllc 1955 W Hamlin Rd Ste 101 Rochester Hills MI 48309-3338 Ph: (810) 618-4374 |
| NPI Number | 1033958475 |
|---|---|
| Provider Enumeration Date | 05/24/2024 |
| Last Update Date | 05/16/2025 |
| Certification Date | 05/16/2025 |
| Medicare PECOS PAC ID | 1153867627 |
|---|---|
| Medicare Enrollment ID | O20240719002373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033958475 | NPI | - | NPPES |
| Provider Name | Jordan Riley Tasker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467004879 PECOS PAC ID: 5294188348 Enrollment ID: I20240125001624 |
| Provider Name | Jack Rodriguez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992323281 PECOS PAC ID: 3072032481 Enrollment ID: I20250528002642 |
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