MEDICARE: RENEWED ROOTS COUNSELING

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1538022389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEWED ROOTS COUNSELING

Provider Business Mailing Address
First Line	:	920 HERITAGE PARK BLVD STE 130
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84041-5609
Country	:	US
Telephone Number	:	801-550-9099
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 HERITAGE PARK BLVD STE 130
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84041-5609
Country	:	US
Telephone Number	:	801-550-9099
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TRISHA D MCWILLIAMS
Credential	:	LCSW
Telephone Number	:	801-510-1777

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

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Directions to “RENEWED ROOTS COUNSELING ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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