Organization
ROOT AND BRANCH PARENTHOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE GOLDWATER LCSW (PRESIDENT)
(301) 219-8195
Entity
Organization
Contact information
Practice address
4054 N LINCOLN AVE STE 2, CHICAGO, IL 60618-3144
(123) 569-0437
Mailing address
4054 N LINCOLN AVE STE 2, CHICAGO, IL 60618-3144
(123) 569-0437
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/11/2023
Last updated
11/20/2024
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