Healthcare Provider Details

I. General information

NPI: 1487598959
Provider Name (Legal Business Name): HEALING ROOTS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 MILLER ST
LEWISTON ID
83501-1944
US

IV. Provider business mailing address

312 MILLER ST
LEWISTON ID
83501-1944
US

V. Phone/Fax

Practice location:
  • Phone: 208-305-2596
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SAVANNAH SCHERTENLEIB
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential:
Phone: 208-305-2596