| Northern Roots Therapy Center | |
|
2960 Triverton Pike Dr Fitchburg WI 53711-5896 | |
| (608) 234-1224 | |
| Not Available |
| Full Name | Northern Roots Therapy Center |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2960 Triverton Pike Dr, Fitchburg, Wisconsin |
| Authorized Official Name and Position | Sarah Vinson (OWNER) |
| Authorized Official Contact | 6084003818 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Roots Therapy Center 2960 Triverton Pike Dr Fitchburg WI 53711-5896 Ph: (608) 234-1224 | Northern Roots Therapy Center 2960 Triverton Pike Dr Fitchburg WI 53711-5896 Ph: (608) 234-1224 |
| NPI Number | 1598300972 |
|---|---|
| Provider Enumeration Date | 11/09/2019 |
| Last Update Date | 04/07/2022 |
| Certification Date | 04/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598300972 | NPI | - | NPPES |
| 100191303 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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