# INTEGRATED ROOTS SUPPORT SERVICES LLC

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

## Provider details

- **NPI number:** 1407640360
- **Authorized official:** RAQUEL MORENO IZAGUIRRE LICSW, LIMHP, PLADC (OWNER)
- **Authorized official phone:** (402) 309-9978

## Contact information

- **Practice address:** 4535 NORMAL BLVD STE 235, LINCOLN, NE 68506-2891
- **Practice address phone:** (402) 413-9758
- **Mailing address:** 4535 NORMAL BLVD STE 235, LINCOLN, NE 68506-2891
- **Mailing address phone:** (402) 440-3939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |

## Other

- **Enumeration date:** 04/07/2025
- **Last updated:** 08/01/2025