Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Connected Roots Youth Counseling Services LLC

Organization Professional Counselor · NPI 1487316808

Connected Roots Youth Counseling Services LLC is a Professional Counselor in Newnan, Georgia. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

300 Ashley Park Blvd Apt 2014
Newnan, GA 30263-6419
Phone: (740) 807-1506
Fax: (678) 306-8663
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X
Clinical Social Worker Taxonomy 1041C0700X

Record details

NPI number1487316808
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stacey Bristow — Owner · (740) 807-1506
NPI enumeratedOctober 13, 2021
Last updated in NPPESMarch 28, 2022
Certification dateMarch 28, 2022
Mailing address300 Ashley Park Blvd Apt 2014, Newnan, GA 30263-6419

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