Provider Demographics
NPI:1649154154
Name:ROOTED IN RESILIENCE MENTAL HEALTH SERVICES, PLLC
Entity type:Organization
Organization Name:ROOTED IN RESILIENCE MENTAL HEALTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-945-7009
Mailing Address - Street 1:1108 S 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-4410
Mailing Address - Country:US
Mailing Address - Phone:630-945-7009
Mailing Address - Fax:
Practice Address - Street 1:611 E STATE ST STE 15
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2372
Practice Address - Country:US
Practice Address - Phone:630-526-6360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty