Provider Demographics
NPI:1548142375
Name:ROOTED IN RESILIENCE THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:ROOTED IN RESILIENCE THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:CARMODY
Authorized Official - Suffix:
Authorized Official - Credentials:ALC
Authorized Official - Phone:319-640-5435
Mailing Address - Street 1:1003 WINCHESTER CIR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-1615
Mailing Address - Country:US
Mailing Address - Phone:319-640-5435
Mailing Address - Fax:
Practice Address - Street 1:3123 WESLEY WAY STE 2
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-2020
Practice Address - Country:US
Practice Address - Phone:334-246-1270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)