# ROOTS NORTH WINGS SOUTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346162229
- **Authorized official:** STEPHANIE DURSO LCSW, LISW-CP (OWNER)
- **Authorized official phone:** (631) 599-6177

## Contact information

- **Practice address:** 715 ISLE VERDE DR, MYRTLE BEACH, SC 29579-7168
- **Practice address phone:** (631) 599-6177
- **Mailing address:** 715 ISLE VERDE DR, MYRTLE BEACH, SC 29579-7168
- **Mailing address phone:** (631) 599-6177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 07/29/2026
- **Last updated:** 07/29/2026