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Organization
GOLDEN ROOTS THERAPY, LLC
Active
Organization
GOLDEN ROOTS THERAPY, LLC
Active
Other names
Golden Roots Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JENNA HERTAUS LPCC (OWNER)
(612) 662-3989
Entity
Organization
Contact information
Practice address
1614 MAHTOMEDI AVE, MAHTOMEDI, MN 55115-1909
(612) 662-3989
Mailing address
4707 HIGHWAY 61 N STE 61, SAINT PAUL, MN 55110-3227
(612) 662-3989
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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