Healthcare Provider Details
I. General information
NPI: 1437969268
Provider Name (Legal Business Name): ROOT & MIND COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14074 TRADE CENTER DR STE 231
FISHERS IN
46038-4577
US
IV. Provider business mailing address
14499 SAMOA ST
FISHERS IN
46038-5210
US
V. Phone/Fax
- Phone: 513-571-8176
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMANDA
HELFRICH-KUHN
Title or Position: CEO
Credential: LCSW
Phone: 513-571-8176