AUTHENTIC ROOTS THERAPY PLLC NPI 1346822046

NPI Information

  • NPI: 1346822046
  • Provider Name: AUTHENTIC ROOTS THERAPY PLLC
  • Classification: Marriage & Family Therapist - 106H00000X
  • Entity Type: Organization
  • Address: 7077 NORTHLAND CIR N STE 330
    MINNEAPOLIS, MN
    ZIP 55428
  • Phone: (612) 799-6652

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NPI Details

AUTHENTIC ROOTS THERAPY PLLC is a marriage family therapist in Minneapolis, MN. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. AUTHENTIC ROOTS THERAPY PLLC NPI is 1346822046. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7077 NORTHLAND CIR N STE 330
MINNEAPOLIS, MN
ZIP 55428-567
Phone: (612) 799-6652

The provider's authorized official is Amanda Wirth .
The authorized official title is Ceo and has the following contact phone number (612) 799-6652.

The enumeration date for this NPI number is 4/22/2021 and was last updated on 8/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1106H00000XMarriage & Family TherapistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17416210MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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