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General NPI Number Information
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NPI Number | 1689539280
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Entity Type | Organization
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Legal Business Name | HEALING ROOTS THERAPY, LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 1601 W LAKES PKWY
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City | WEST DES MOINES
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State | IA
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Zip | 50266-8230
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Country | US
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Telephone | 319-573-6461
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Fax | 515-855-3201
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Provider Business Mailing Address
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Address Line | 1322 NW BENNINGTON DR
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City | WAUKEE
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State | IA
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Zip | 50263-7210
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Country | US
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Telephone | 319-573-6461
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Fax | 515-855-3201
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Authorized Official
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Title or Position | OWNER
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Name | DEANNA ENGRAV
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Credential | LMFT
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Telephone | 319-573-6461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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