Reflective Roots Psychotherapy & Healing, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

REFLECTIVE ROOTS PSYCHOTHERAPY & HEALING, LLC

Practice address

1186 121St St
Roberts, WI 54023-8538

Phone

(715) 201-4563

NPI assigned

May 18, 2024

Last updated

Apr 16, 2026By 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

Stephanie J Larson, MSW, LICSW, LCSWNPI 1740875608

Title

Psychotherapist

Phone

(715) 201-4563

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie Larson, MSW, LICSW, LCSW

  • Clinical Social Worker
  • Roberts, WI
  • NPI 1740875608
  NPD Authorized official

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

{
    "created_epoch": "1715990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1972352177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 CARMICHAEL RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167759",
            "telephone_number": "715-201-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1186 121ST ST",
            "city": "ROBERTS",
            "state": "WI",
            "postal_code": "540238538",
            "telephone_number": "715-201-4563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "990 Hillcrest St Ste 108",
            "address_purpose": "LOCATION",
            "city": "Baldwin",
            "state": "WI",
            "postal_code": "540029263",
            "country_code": "US",
            "telephone_number": "715-201-4563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REFLECTIVE ROOTS PSYCHOTHERAPY & HEALING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-18",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "715-201-4563",
        "authorized_official_credential": "MSW, LICSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Roberts, WI
• Providers in Roberts, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.