# ROOTS PSYCHIATRY & WELLNESS

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

## Provider details

- **NPI number:** 1841170842
- **Authorized official:** DR. BETH WILSON PHD, LPCS, LCMHCS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (803) 675-8227

## Contact information

- **Practice address:** 4609 CHARLOTTE HWY STE 3, LAKE WYLIE, SC 29710-8025
- **Practice address phone:** (803) 373-2598
- **Practice address fax:** (866) 884-5371
- **Mailing address:** 4609 CHARLOTTE HWY STE 3, LAKE WYLIE, SC 29710-8025
- **Mailing address phone:** (803) 373-2598
- **Mailing address fax:** (866) 884-5371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/03/2025
- **Last updated:** 09/03/2025