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Organization
HEALING ROOTS THERAPY GROUP
Active
Organization
HEALING ROOTS THERAPY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA LEE DIELEMAN LMSW (OWNER)
(616) 485-5920
Entity
Organization
Contact information
Practice address
327 BRISTOL AVE NW, GRAND RAPIDS, MI 49504-4927
(616) 485-5920
Mailing address
327 BRISTOL AVE NW, GRAND RAPIDS, MI 49504-4927
(616) 485-5920
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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