Healthcare Provider Details

I. General information

NPI: 1134023443
Provider Name (Legal Business Name): SIMPLY ROOTED COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 RED RIVER AVE S STE 220
COLD SPRING MN
56320-2607
US

IV. Provider business mailing address

20 RED RIVER AVE S STE 220
COLD SPRING MN
56320-2607
US

V. Phone/Fax

Practice location:
  • Phone: 320-289-4617
  • Fax:
Mailing address:
  • Phone: 320-289-4617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JENNIFER LUND
Title or Position: OWNER
Credential:
Phone: 320-289-4617