Community Roots Counseling, Llc

LBN: Community Roots Counseling, Llc
Community Roots Counseling, Llc is an health care organization with primary practice located at 494 State St Ste 270 , Salem OR 97301-3647. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Community Roots Counseling, Llc can be contacted via phone (503) 583-2121, or through Dimas, Jes via phone (503) 583-2121.

Contact Information

Primary practice address
494 State St Ste 270 Salem OR 97301-3647
Phone: (503) 583-2121
Fax: (855) 855-4872
Website:
Map and Directions
Authorized official contact:
Name: Dimas, Jes LCSW, LICSW, LSSW
Phone: (503) 583-2121

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1417567983
LBN Legal business name Community Roots Counseling, Llc
DBA Doing business as
Authorized official Dimas, Jes LCSW, LICSW, LSSW
Entity Organization
Organization subpart 1 No
Enumeration date Aug 8th, 2020
Last updated Sep 12th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417567983 NPPES
Oregon MEDICAID 500688776

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