| Magnolia Roots Collective And Counseling Pllc | |
|
405 47th St West Des Moines IA 50265-7100 | |
| (704) 253-0450 | |
| Not Available |
| Full Name | Magnolia Roots Collective And Counseling Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 405 47th St, West Des Moines, Iowa |
| Authorized Official Name and Position | Candace Shultz (OWNER) |
| Authorized Official Contact | 7042530450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Roots Collective And Counseling Pllc 405 47th St West Des Moines IA 50265-7100 Ph: (704) 253-0450 | Magnolia Roots Collective And Counseling Pllc 405 47th St West Des Moines IA 50265-7100 Ph: (704) 253-0450 |
| NPI Number | 1083502249 |
|---|---|
| Provider Enumeration Date | 06/26/2025 |
| Last Update Date | 06/26/2025 |
| Certification Date | 06/26/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083502249 | NPI | - | NPPES |
| 1861189508 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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