Provider Demographics
NPI:1306527908
Name:MINDFUL ROOTS COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:MINDFUL ROOTS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULDT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MH
Authorized Official - Phone:605-846-7038
Mailing Address - Street 1:634 S ROOSEVELT ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-6593
Mailing Address - Country:US
Mailing Address - Phone:605-846-7038
Mailing Address - Fax:605-401-4087
Practice Address - Street 1:634 S ROOSEVELT ST STE 4
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-6593
Practice Address - Country:US
Practice Address - Phone:605-846-7038
Practice Address - Fax:605-401-4087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty