Jacob Russell Root, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF60918068 Issued in WA

Practice address

902 E 2ND St Ste 224
Winona, MN 55987-6509

Phone

(651) 272-9562

NPI assigned

Jul 16, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Root Counseling Services LLC

  • Adult Mental Health Clinic/Center
  • Winona, MN
  • NPI 1194392159
  NPD Authorized official

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1477039246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 E 2ND ST STE 224",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876509",
            "telephone_number": "651-272-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 E 2ND ST STE 224",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876509",
            "telephone_number": "651-272-9562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1813 Sumner Ave",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "WA",
            "postal_code": "98520",
            "country_code": "US",
            "telephone_number": "360-538-1293 x58051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 4th Ave W Ste H",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "98502",
            "country_code": "US",
            "telephone_number": "360-328-1982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROOT",
        "first_name": "JACOB",
        "middle_name": "RUSSELL",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3588",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60918068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alizabeth Leanne Roller
• Tina Roloff
• Richard L Romeyn, M.D.
• Ron McGuire Family Therapy Center
• Root Counseling Services LLC
• Stephanie Spring Rosado
• Jason James Rosenbush, D.C.
• Elise Rothbauer
• John D Rowekamp, MD
• Madeline Maria Rueb, PA-C

• Marriage & Family Therapist in Winona, MN
• Providers in Winona, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.