Organization Active NPI

Mindful Roots Wellness PLLC

  • Adult Mental Health Clinic/Center
  • Seattle, WA
National Provider Identifier
1336964527
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MINDFUL ROOTS WELLNESS PLLC
Practice address
108 S Jackson St Ste 301
Seattle, WA 98104-2872
Phone
(509) 724-0152
NPI assigned
Nov 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Amy Hersh, MA, LMHCNPI 1144937483
Title
Owner
Phone
(509) 724-0152

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

108 S Jackson St Ste 301
Seattle, WA 98104-2872

Mailing address

5706 17TH Ave NW Unit 17509
Seattle, WA 98127-1650
Phone (509) 724-0152

National Provider Directory

National Provider Directory

Locations

5706 17th Ave NW
Unit 17509
Seattle, WA 98127

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": "1732147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1336964527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5706 17TH AVE NW UNIT 17509",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981271650",
            "telephone_number": "509-724-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S JACKSON ST STE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042872",
            "telephone_number": "509-724-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL ROOTS WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "HERSH",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-724-0152",
        "authorized_official_credential": "MA, LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.