Organization Active NPI

Root & Branch Wellness Collaborative, LLC

  • Adult Mental Health Clinic/Center
  • Canton, MI
National Provider Identifier
1073311023
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
ROOT & BRANCH WELLNESS COLLABORATIVE, LLC
Practice address
266 Constitution St
Canton, MI 48188-6719
Phone
(734) 743-2286
NPI assigned
Mar 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Elise McNulty, LMSWNPI 1356659411
Title
Member
Phone
(734) 743-2286

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
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

266 Constitution St
Canton, MI 48188-6719

Mailing address

266 Constitution St
Canton, MI 48188-6719

National Provider Directory

National Provider Directory

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": "1741132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1073311023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 CONSTITUTION ST",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481886719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 CONSTITUTION ST",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481886719",
            "telephone_number": "734-743-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOT & BRANCH WELLNESS COLLABORATIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "ELISE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "734-743-2286",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.