# LIBERATED ROOTS WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992599815
- **Authorized official:** BRIDGET O'CONNOR MSW, LICSW (CO- PRESIDENT)
- **Authorized official phone:** (630) 220-1757

## Contact information

- **Practice address:** 2021 E HENNEPIN AVE, MINNEAPOLIS, MN 55413-2700
- **Practice address phone:** (630) 220-1757
- **Mailing address:** 2021 E HENNEPIN AVE, MINNEAPOLIS, MN 55413-2700
- **Mailing address phone:** (630) 220-1757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |

## Other

- **Enumeration date:** 04/07/2025
- **Last updated:** 04/07/2025