Organization
ROOTED COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA PARKS LCSW (OWNER, CLINICAL SOCIAL WORKER)
(630) 935-5662
Entity
Organization
Contact information
Practice address
13242 S ROUTE 59 STE 102A, PLAINFIELD, IL 60585-5438
(331) 465-9588
(331) 625-6448
Mailing address
221 CAROL LN, BOLINGBROOK, IL 60440-1694
(630) 935-5662
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149015311
CLINICAL SOCIAL WORKER LICENSE NUMBER
IL
Enumeration date
09/15/2020
Last updated
12/17/2020
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