Organization
MARIAH ROOT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAH ROOT LMSW (PSYCHOTHERAPIST)
(518) 862-3456
Entity
Organization
Contact information
Practice address
1422 WEALTHY ST SE, GRAND RAPIDS, MI 49506-2717
(517) 862-3456
Mailing address
2563 RAYMOND AVE SE, GRAND RAPIDS, MI 49507-3928
(517) 862-3456
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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