Organization
NORTHERN ROOTS THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH VINSON LCSW, SAL, CFRC (OWNER)
(608) 400-3818
Entity
Organization
Contact information
Practice address
2960 TRIVERTON PIKE DR, FITCHBURG, WI 53711-5896
(608) 234-1224
Mailing address
2960 TRIVERTON PIKE DR, FITCHBURG, WI 53711-5896
(608) 234-1224
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100191303
—
WI
Enumeration date
11/09/2019
Last updated
04/07/2022
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