| Roots Counseling And Assessments | |
|
1760 N Main St Cedar City UT 84721-7775 | |
| (435) 359-2460 | |
| Not Available |
| Full Name | Roots Counseling And Assessments |
|---|---|
| Speciality | Counselor |
| Location | 1760 N Main St, Cedar City, Utah |
| Authorized Official Name and Position | Rochelle Mclelland (CEO) |
| Authorized Official Contact | 8012018689 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots Counseling And Assessments 359 W 900 N Cedar City UT 84721-5119 Ph: (801) 201-8689 | Roots Counseling And Assessments 1760 N Main St Cedar City UT 84721-7775 Ph: (435) 359-2460 |
| NPI Number | 1588172068 |
|---|---|
| Provider Enumeration Date | 01/18/2018 |
| Last Update Date | 01/18/2018 |
| Medicare PECOS PAC ID | 8224484209 |
|---|---|
| Medicare Enrollment ID | O20231026004238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588172068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 8378553-6004 (Utah) | Primary |
| 101YM0800X | Counselor - Mental Health | 8367569-6004 (Utah) | Secondary |
| Provider Name | Micah J Bulloch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679082952 PECOS PAC ID: 7214383298 Enrollment ID: I20231026004269 |
| Provider Name | Rochelle Mclelland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497044994 PECOS PAC ID: 0042666026 Enrollment ID: I20240118001179 |
| Provider Name | Milton Douglas Mclelland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922356088 PECOS PAC ID: 9133575111 Enrollment ID: I20240130002774 |
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