Healthcare Provider Details

I. General information

NPI: 1023954609
Provider Name (Legal Business Name): ROOT & RISE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11515 S BLACKBOB RD
OLATHE KS
66062-4901
US

IV. Provider business mailing address

11515 S BLACKBOB RD
OLATHE KS
66062-4901
US

V. Phone/Fax

Practice location:
  • Phone: 913-489-7336
  • Fax:
Mailing address:
  • Phone: 913-489-7336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHANNON RENEE LIEBURN
Title or Position: OWNER & PROVIDER
Credential: LPC
Phone: 913-489-7336