# ROOTED RELATIONAL THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rooted Relational Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073096780
- **Authorized official:** DOUG RICHARD MAMFT (OWNER AND THERAPIST)
- **Authorized official phone:** (570) 884-4662

## Contact information

- **Practice address:** 400 MARKET ST, MIFFLINBURG, PA 17844-1249
- **Practice address phone:** (570) 884-4662
- **Mailing address:** PO BOX 54, MIFFLINBURG, PA 17844-0054
- **Mailing address phone:** (570) 884-4662

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2018
- **Last updated:** 09/18/2018