Provider Demographics
NPI:1609675479
Name:ROOTED IN THERAPY, LLC
Entity type:Organization
Organization Name:ROOTED IN THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVANGJELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZYLYFTARI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:407-307-9719
Mailing Address - Street 1:401 N MILLS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5735
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4403 VINELAND RD STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-7180
Practice Address - Country:US
Practice Address - Phone:407-796-1871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)