Provider Demographics
NPI:1932886058
Name:HEALTHY ROOTS THERAPY LLC
Entity Type:Organization
Organization Name:HEALTHY ROOTS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHMITZER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:989-525-6039
Mailing Address - Street 1:5603 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-6375
Mailing Address - Country:US
Mailing Address - Phone:989-525-6039
Mailing Address - Fax:
Practice Address - Street 1:5603 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-6375
Practice Address - Country:US
Practice Address - Phone:989-525-6039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty