Southern Roots Therapeutic Services Llc | |
74 Falin Ln Williamsburg KY 40769-1791 | |
(606) 304-7994 | |
Not Available |
Full Name | Southern Roots Therapeutic Services Llc |
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Speciality | Counselor - Professional |
Location | 74 Falin Ln, Williamsburg, Kentucky |
Authorized Official Name and Position | Melissa Hansford (OWNER) |
Authorized Official Contact | 6063047994 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southern Roots Therapeutic Services Llc 74 Falin Ln Williamsburg KY 40769-1791 Ph: (606) 304-7994 | Southern Roots Therapeutic Services Llc 74 Falin Ln Williamsburg KY 40769-1791 Ph: (606) 304-7994 |
NPI Number | 1851155014 |
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Provider Enumeration Date | 02/08/2024 |
Last Update Date | 02/08/2024 |
Certification Date | 02/08/2024 |
Identifier | Type | State | Issuer |
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1851155014 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Self Renew Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 Cumberland Ave, Williamsburg, KY 40769 Phone: 606-369-3180 |