Healthcare Provider Details

I. General information

NPI: 1235960253
Provider Name (Legal Business Name): FROM ROOT TO BLOOM COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 N CLAY AVE STE 215
KIRKWOOD MO
63122-4068
US

IV. Provider business mailing address

214 N CLAY AVE STE 215
KIRKWOOD MO
63122-4068
US

V. Phone/Fax

Practice location:
  • Phone: 314-384-9904
  • Fax:
Mailing address:
  • Phone: 314-384-9904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MEGAN RENEE PATTERSON
Title or Position: CEO
Credential: M. ED, NCC, PLPC
Phone: 636-312-8483