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Organization

INTEGRATED ROOTS SUPPORT SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAQUEL MORENO IZAGUIRRE LICSW, LIMHP, PLADC (OWNER)
(402) 309-9978
Entity
Organization

Contact information

Practice address
4535 NORMAL BLVD STE 235, LINCOLN, NE 68506-2891
(402) 413-9758
Mailing address
4535 NORMAL BLVD STE 235, LINCOLN, NE 68506-2891
(402) 440-3939

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
103TC1900X
Counseling Psychologist
1041C0700X
Clinical Social Worker
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
04/07/2025
Last updated
08/01/2025
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