Root Wellness Studio, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.006965 Issued in IL

Legal business name

ROOT WELLNESS STUDIO, LLC

Practice address

5378 Sterling Dr
Studio 3
Boulder, CO 80301-2351

Phone

(303) 505-3216

NPI assigned

Sep 5, 2013

Last updated

Apr 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy J Lynn, LCPC, ATR-BC

Title

Ceo

Phone

(303) 505-3216

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460073600000",
    "number": "1245665538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5378 STERLING DR",
            "address_2": "STUDIO 3",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012351",
            "telephone_number": "303-505-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5378 STERLING DR",
            "address_2": "STUDIO 3",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012351",
            "telephone_number": "303-505-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOT WELLNESS STUDIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2016-04-08",
        "status": "A",
        "authorized_official_last_name": "LYNN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-505-3216",
        "authorized_official_credential": "LCPC, ATR-BC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.006965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Boulder, CO
• Providers in Boulder, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.