MEDICARE: ROOTS & WINGS THERAPY AND WELLNESS PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1164236154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROOTS & WINGS THERAPY AND WELLNESS PLC

Provider Business Mailing Address
First Line	:	2608 HAMILTON BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-4048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2608 HAMILTON BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-4048
Country	:	US
Telephone Number	:	712-227-3425
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	SARAH STEVENS
Credential	:	LISW
Telephone Number	:	712-227-3425

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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