MEDICARE: HEALING ROOTS THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1457158073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING ROOTS THERAPY LLC

Provider Business Mailing Address
First Line	:	5838 W 21ST ST N STE 100
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67205-1795
Country	:	US
Telephone Number	:	316-249-1541
Fax Number	:

Provider Business Practice Location Address
First Line	:	5838 W 21ST ST N STE 100
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67205-1795
Country	:	US
Telephone Number	:	316-249-1541
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRITTAN L SCHURLE
Credential	:	LPC
Telephone Number	:	316-249-1541

Provider Enumeration Date	:	03/01/2025
Last Update Date	:	12/08/2025

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