Organization
HEARTFUL ROOTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA GERSHWIN MSW, LCSW (LICENSED CLINICAL SOCIAL WORKER)
(802) 222-0885
Entity
Organization
Contact information
Practice address
278 VANCE RD, DANVILLE, VT 05828-9465
(802) 222-0885
Mailing address
278 VANCE RD, DANVILLE, VT 05828-9465
(720) 220-7525
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6703410
—
VT
Enumeration date
04/26/2021
Last updated
04/26/2021
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