Organization
RADIANT ROOTS CONNECTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRIZER SMITH LCSW (OWNER)
(612) 382-8783
Entity
Organization
Contact information
Practice address
1200 MENDELSSOHN AVE N STE 211, GOLDEN VALLEY, MN 55427-4376
(612) 382-8783
Mailing address
1200 MENDELSSOHN AVE N STE 211, GOLDEN VALLEY, MN 55427-4376
(612) 382-8783
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/26/2024
Last updated
01/26/2024
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