ROOTS RENEWAL COUNSELING (NPI# 1811492077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811492077 |
| Entity Type | Organization |
| Organization Name | ROOTS RENEWAL COUNSELING |
| Practice Address |
11042 Manchester Rd Kirkwood MO 63122-1244 |
| Practice Telephone | 4022802735 |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |
| Authorized Official Name | STEPHANIE STOCKHAM-RONOLLO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4022802735 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
11042 MANCHESTER RD |
| City | KIRKWOOD |
| State | MO |
| Zip Code | 63122-1244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790994804 | Stephanie Christine Schulte | Counselor | 11042 Manchester Rd, Kirkwood, MO 63122-1244 | 2007-05-22 |
| 1598394793 | Paula Heller | Counselor | 11042 Manchester Rd, Kirkwood, MO 63122-1244 | 2020-04-08 |
| 1962031385 | Shanti Source Counseling LLC | Social Worker | 11042 Manchester Rd, Kirkwood, MO 63122-1244 | 2020-04-07 |
| 1356970263 | Ayana Jackson | Counselor | 11042 Manchester Rd, Kirkwood, MO 63122-1244 | 2020-04-02 |
| 1811534647 | T.a.v.e.r.n. Health and Wellness, LLC | Nutritionist | 11042 Manchester Rd, Kirkwood, MO 63122-1244 | 2019-11-27 |
| 1962976084 | Diversified Health and Wellness Center | Public Health or Welfare | 11042 Manchester Rd, Kirkwood, MO 63122-1244 | 2019-01-12 |
| 1699249722 | Ellen M Nickrent | Counselor | 11042 Manchester Rd, Kirkwood, MO 63122-1244 | 2019-01-11 |
| 1760997159 | Dawn Gross LLC | Social Worker | 11042 Manchester Rd, Kirkwood, MO 63122-1244 | 2017-12-06 |
| 1831647809 | Joyce Hathaway | Counselor | 11042 Manchester Rd, Kirkwood, MO 63122-1244 | 2016-09-19 |
| 1790194140 | Caitlin D Fahrner | Counselor | 11042 Manchester Rd, Kirkwood, MO 63122 | 2014-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659933174 | Keela Rushing | Physical Therapist | 439 S Kirkwood Rd Ste 200, Kirkwood, MO 63122 | 2019-07-04 |
| 1730643461 | Kirkwood Family Dental | Dentist | 333 S Kirkwood Road, Suite 105, Kirkwood, MO 63122 | 2019-01-28 |
| 1477061166 | Total Access Urgent Care, PC | Clinic/Center | 2980 Dougherty Ferry Rd, Saint Louis, MO 63122 | 2018-01-16 |
| 1760933469 | Missouri Cvs Pharmacy, L.l.c | Durable Medical Equipment & Medical Supplies | 10820 Manchester Rd, Kirkwood, MO 63122 | 2016-10-18 |
| 1518321041 | M. Kathleen Blanchard | Counselor | 11042 Manchester Rd., Kirkwood, MO 63122 | 2016-04-11 |
| 1265801914 | Kim Grega | Counselor | 700 S Kirkwood Rd, Kirkwood, MO 63122 | 2015-09-23 |
| 1245617943 | Mark Edward Taylor | Dentist | 610 North Geyer, Kirkwood, MO 63122 | 2015-05-01 |
| 1467843094 | Mary Elizabeth Boomgarden | Physical Therapist | 9645 Big Bend Boulevard, Saint Louis, MO 63122 | 2015-02-18 |
| 1760725717 | Michael Diller Counseling | Counselor | 144 W Madison Avenue, Kirkwood, MO 63122 | 2013-03-28 |
| 1427309954 | Anne Marie Delaplain | Dentist | 725 Laclede Station Road, Webster Groves, MO 63122 | 2012-09-24 |
| Find all providers in zip 63122 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053953422 | Kirwood Medication Assisted Treatments | Clinic/Center | 111 Prospect Ave Ste 201, Kirkwood, MO 63122-6052 | 2019-10-17 |
| 1770147548 | Mary Jane Lane Lmft LLC | Clinic/Center | 412 S Clay Ave # 212, Kirkwood, MO 63122-5860 | 2019-04-27 |
| 1548868821 | White Stone Psychological Services LLC | Clinic/Center | 140 Prospect Ave Ste U, Kirkwood, MO 63122-6024 | 2020-10-09 |
| 1366073546 | Awakened Life Healing, LLC | Clinic/Center | 10801 Big Bend Rd, Kirkwood, MO 63122-6055 | 2020-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144949 | New Life Mission Inn - Missouri | Clinic/Center | 114 W. South, Perryville, MO 63775 | 2020-11-02 |
| 1912511379 | Community Connect LLC | Clinic/Center | 3080 Churchill Dr, Florissant, MO 63033-1116 | 2020-09-03 |
| 1447864848 | Valiant Therapeutic Services | Clinic/Center | 4444 N Belleview Ave Ste 100, Kansas City, MO 64116-1507 | 2020-09-02 |
| 1598377673 | Ubuntu Counseling LLC | Clinic/Center | 8400 Atherton Dr Apt 2s, Saint Louis, MO 63130-1001 | 2020-08-19 |
| 1982229498 | Rebecca Wallace Counseling LLC | Clinic/Center | 207 Peach Way, Suite 110, Columbia, MO 65203 | 2020-06-10 |
| 1679102230 | Renew Counseling LLC | Clinic/Center | 312 W Washington St, Kirksville, MO 63501-2876 | 2020-04-06 |
| 1891329322 | Individual Marriage and Family Enrichment LLC | Clinic/Center | 601 W Nifong Blvd Ste 1e, Columbia, MO 65203-6804 | 2020-02-24 |
| 1861024754 | Chrysalis Wellness LLC | Clinic/Center | 3863 S Campbell Ave Ste A, Springfield, MO 65807-5339 | 2020-02-07 |
| 1275178451 | Awaken360, Inc. | Clinic/Center | 829 W Atlantic St, Springfield, MO 65803-1517 | 2019-11-12 |
| 1558921361 | Next Steps Therapy & Coaching, LLC | Clinic/Center | 1040 Fairgrounds Road, St. Charles, MO 63301 | 2019-06-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.