Authentic Roots Therapy Pllc

LBN: Authentic Roots Therapy Pllc
Authentic Roots Therapy Pllc is an health care organization with primary practice located at 7077 Northland Cir N Ste 330 , Minneapolis MN 55428-1567. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as the primary health care specialty. Authentic Roots Therapy Pllc can be contacted via phone (612) 799-6652, or through Wirth, Amanda via phone (612) 799-6652.

Contact Information

Primary practice address
7077 Northland Cir N Ste 330 Minneapolis MN 55428-1567
Phone: (612) 799-6652
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wirth, Amanda LMFT
Phone: (612) 799-6652

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X

Profile Details

NPI number 1346822046
LBN Legal business name Authentic Roots Therapy Pllc
DBA Doing business as
Authorized official Wirth, Amanda LMFT
Entity Organization
Organization subpart 1 No
Enumeration date Apr 22nd, 2021
Last updated Aug 10th, 2021 - about 4 years ago

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 1346822046 NPPES
Minnesota MEDICAID 7416210

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