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ROOTED THERAPY AND WELLNESS, PLLC
NPI 1811719040
Social Worker - Clinical in Fayetteville, AR

Active since October 29, 2024
3546 E GREYSTONE DR, FAYETTEVILLE, AR 72764(509) 434-6386 Get Directions Write a Review

NPPES record last updated: October 29, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Rooted Therapy And Wellness, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROOTED THERAPY AND WELLNESS, PLLC (NPI 1811719040) is a healthcare organization registered as a clinical in Fayetteville, Arkansas and active in the NPI registry since October 2024. The organization lists Michelle Wise Gendusa, Owner/therapist, as its authorized official.

NPPES Registry Identity

NPI1811719040
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameROOTED THERAPY AND WELLNESS, PLLC
Location Address3546 E GREYSTONE DRFayetteville, AR 72764-6860
Mailing Address3546 E Greystone DrFayetteville, AR 72764-6860 · (509) 434-6386
Phone(509) 434-6386
Organization SubpartNo
Authorized OfficialMichelle Wise GendusaOwner/therapist · (509) 434-6386
Enumeration DateOctober 29, 2024
NPPES CertifiedOctober 29, 2024
✔ NPI 1811719040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3546 E GREYSTONE DR, Fayetteville, AR 72764
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rooted Therapy And Wellness, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Rooted Therapy And Wellness, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Michelle Wise Gendusa, LICSW
Clinical Social Worker
NPI 1598505513
3546 W GREYSTONE DR.
Fayetteville, AR 72764
(509) 434-6386
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rooted Therapy And Wellness, PLLC's NPI number?

The NPI number for Rooted Therapy And Wellness, PLLC is 1811719040. It was assigned to this organization in the NPPES registry on October 29, 2024.

Where is Rooted Therapy And Wellness, PLLC located?

Rooted Therapy And Wellness, PLLC is located at 3546 E Greystone Dr, Fayetteville, AR 72764. The listed phone number is (509) 434-6386.

What is Rooted Therapy And Wellness, PLLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Rooted Therapy And Wellness, PLLC enrolled in Medicare?

Yes. Rooted Therapy And Wellness, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Rooted Therapy And Wellness, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Rooted Therapy And Wellness, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Rooted Therapy And Wellness, PLLC was last updated on October 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.