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Organization
REVIVING THE ROOTS COUNSELING, LLC
Active
Organization
REVIVING THE ROOTS COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY BOSTIAN-MILLER LMHC (OWNER/MENTAL HEALTH THERAPIST)
(317) 385-8661
Entity
Organization
Contact information
Practice address
20 AIRPORT RD STE 1300, BROWNSBURG, IN 46112-2047
(317) 426-7251
Mailing address
3119 LAKEWOOD DR, INDIANAPOLIS, IN 46234-9150
(317) 385-8661
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
05/30/2024
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