Organization Active NPI

Roots Therapy & Consulting LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
National Provider Identifier
1043700800
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ROOTS THERAPY & CONSULTING LLC
Practice address
730 E 38TH St Ste 102
Minneapolis, MN 55407-5218
Phone
(612) 964-7869
Fax
(651) 925-0606
NPI assigned
May 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julie Jong Koch, LICSWNPI 1932447141
Title
Owner
Phone
(612) 234-1072

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

730 E 38TH St Ste 102
Minneapolis, MN 55407-5218

Mailing address

3036 11TH Ave S
Minneapolis, MN 55407-1606
Phone (612) 964-7869

Other practice location 1

310 E 38th St # 217
Minneapolis, MN 55409-1300
Phone (612) 964-7869 ext. 47869

National Provider Directory

National Provider Directory

Locations

310 E 38th St
#217
Minneapolis, MN 55409
Phone 6129647869 ext. 47869

730 E 38th St
Ste 102
Minneapolis, MN 55407
Phone (612) 964-7869

2920 Bryant Ave S
Ste 112
Minneapolis, MN 55408

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1043700800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3036 11TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071606",
            "telephone_number": "612-964-7869",
            "fax_number": "651-925-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 E 38TH ST STE 102",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554075218",
            "telephone_number": "612-964-7869",
            "fax_number": "651-925-0606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 E 38th St # 217",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554091300",
            "country_code": "US",
            "telephone_number": "612-964-7869 x47869",
            "fax_number": "651-925-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROOTS THERAPY & CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-16",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "JONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-234-1072",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.