Provider Demographics
NPI:1033705850
Name:ROOT & RISE PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:ROOT & RISE PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRINE
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:BUTLER HEPLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:207-307-7704
Mailing Address - Street 1:9 MAY ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6416
Mailing Address - Country:US
Mailing Address - Phone:207-307-7704
Mailing Address - Fax:866-615-7655
Practice Address - Street 1:9 MAY ST STE 3
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6416
Practice Address - Country:US
Practice Address - Phone:207-307-7704
Practice Address - Fax:866-615-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty