Provider Demographics
NPI:1629826086
Name:FIRMLY ROOTED COUNSELING LLC
Entity type:Organization
Organization Name:FIRMLY ROOTED COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIAUNA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:CLAY-POTTS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-910-3371
Mailing Address - Street 1:2500 DALLAS HWY SUITE 202 #5144
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-7505
Mailing Address - Country:US
Mailing Address - Phone:404-910-3371
Mailing Address - Fax:
Practice Address - Street 1:610 KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:GA
Practice Address - Zip Code:30079-1124
Practice Address - Country:US
Practice Address - Phone:404-910-3371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health