Healthcare Provider Details

I. General information

NPI: 1356136048
Provider Name (Legal Business Name): ROOT AND RESOLVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2025
Last Update Date: 04/12/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10808 COURAGEOUS DR
INDIANAPOLIS IN
46236-9570
US

IV. Provider business mailing address

10808 COURAGEOUS DR
INDIANAPOLIS IN
46236-9570
US

V. Phone/Fax

Practice location:
  • Phone: 317-532-7295
  • Fax:
Mailing address:
  • Phone: 317-532-7295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALISON HUNDT RUSSELL
Title or Position: OWNER
Credential: M.ED., LMHC
Phone: 317-532-7295