Healthcare Provider Details
I. General information
NPI: 1538024724
Provider Name (Legal Business Name): VERDANT ROOTS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2303 WYCLIFF ST STE 358
SAINT PAUL MN
55114-1272
US
IV. Provider business mailing address
4920 STEVENS AVE
MINNEAPOLIS MN
55419-5622
US
V. Phone/Fax
- Phone: 507-320-1345
- Fax:
- Phone: 651-272-8293
- 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:
ALYSON
WEBSTER
Title or Position: OWNER, LPCC
Credential: LPCC
Phone: 651-272-8293