Ivy Roots LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

IVY ROOTS LLC

Doing business as

Ivy Roots LLC

Practice address

3422 R St
Richmond, VA 23223-6877

Phone

(804) 896-6607

Fax

(804) 896-6607

NPI assigned

Mar 3, 2025

Last updated

Mar 3, 2025By 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

Shanell Janese Williams, B.S, QMHP-A

Title

Ceo/ Owner

Phone

(804) 896-6607

Specialties & licenses 2

Addresses

Other names 1

• Ivy Roots LLC Doing business as

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1902603434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3422 R ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232236877",
            "telephone_number": "804-896-6607",
            "fax_number": "804-896-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3422 R ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232236877",
            "telephone_number": "804-896-6607",
            "fax_number": "804-896-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY ROOTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SHANELL",
        "authorized_official_middle_name": "JANESE",
        "authorized_official_title_or_position": "CEO/ OWNER",
        "authorized_official_telephone_number": "804-896-6607",
        "authorized_official_credential": "B.S, QMHP-A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ivy Roots LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Case Management Agency in Richmond, VA
• Providers in Richmond, VA by specialty
• Case Management Agency in Virginia

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