Provider Demographics
NPI:1871479618
Name:ROOTED INTEGRATIVE THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:ROOTED INTEGRATIVE THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:217-454-8708
Mailing Address - Street 1:2926 N PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-1550
Mailing Address - Country:US
Mailing Address - Phone:217-454-8708
Mailing Address - Fax:217-706-5779
Practice Address - Street 1:2926 N PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-1550
Practice Address - Country:US
Practice Address - Phone:217-454-8708
Practice Address - Fax:217-706-5779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty