Provider Demographics
NPI:1548149024
Name:THE ROOTED LILY, LLC
Entity type:Organization
Organization Name:THE ROOTED LILY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANEL
Authorized Official - Middle Name:MONET
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-938-7590
Mailing Address - Street 1:2400 HERODIAN WAY SE STE 220
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-8500
Mailing Address - Country:US
Mailing Address - Phone:404-436-1765
Mailing Address - Fax:
Practice Address - Street 1:3055 HIGHGREEN TRL
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-7998
Practice Address - Country:US
Practice Address - Phone:678-938-7590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty