Provider Demographics
NPI:1689473860
Name:RESILIENT ROOTS COUNSELING SERVICE PLLC
Entity type:Organization
Organization Name:RESILIENT ROOTS COUNSELING SERVICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OUTPATIENT THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SENECA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-355-6907
Mailing Address - Street 1:2304 S MIAMI BLVD STE 123
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5797
Mailing Address - Country:US
Mailing Address - Phone:919-355-6907
Mailing Address - Fax:984-250-9071
Practice Address - Street 1:2304 S MIAMI BLVD STE 123
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-5797
Practice Address - Country:US
Practice Address - Phone:919-355-6907
Practice Address - Fax:984-250-9071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty