Organization
ROOTED SELF COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAXINE IIDA (OWNER)
(571) 926-6453
Entity
Organization
Contact information
Practice address
45571 RUISLIP MANOR WAY, STERLING, VA 20166-9239
(571) 926-6453
Mailing address
45571 RUISLIP MANOR WAY, STERLING, VA 20166-9239
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/11/2026
Last updated
05/11/2026
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