Organization
ROOTED2THRIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SINIQUA R COPELAND LCSW (MGR/OWNER)
(614) 496-4515
Entity
Organization
Contact information
Practice address
6961 HERITAGE DR STE B, PORT ST LUCIE, FL 34952-8229
(619) 975-3746
Mailing address
3100 SE FEDERAL HWY # 1014, STUART, FL 34994-5531
(619) 975-3746
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/12/2025
Last updated
03/24/2025
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