Provider Demographics
NPI:1427730019
Name:HEALING ROOTS COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:HEALING ROOTS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINUETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUMPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-882-4325
Mailing Address - Street 1:5788 STATE ROAD 11
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-3873
Mailing Address - Country:US
Mailing Address - Phone:262-882-4325
Mailing Address - Fax:
Practice Address - Street 1:5788 STATE ROAD 11
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-3873
Practice Address - Country:US
Practice Address - Phone:262-882-4325
Practice Address - Fax:262-429-8112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty