Wild Roots Psychotherapy & Family Counseling, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WILD ROOTS PSYCHOTHERAPY & FAMILY COUNSELING, INC.

Practice address

35 Harrington Ave Unit 1316
Shrewsbury, MA 01545-5277

Phone

(951) 460-0005

NPI assigned

Dec 5, 2023

Organization subpart

No

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

Authorized official

Name

Andie TranNPI 1376205989

Title

Ceo/Owner

Phone

(951) 460-0005

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andie Tran, DMFT

  • Marriage & Family Therapist
  • Shrewsbury, MA
  • NPI 1376205989
  NPD Authorized official

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1982471553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 MORNING STAR DR",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 HARRINGTON AVE UNIT 1316",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015455277",
            "telephone_number": "951-460-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD ROOTS PSYCHOTHERAPY & FAMILY COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "ANDIE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "951-460-0005"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joylette Watt, RPH
• Jarrett Weaner
• Haylee Wetnicka
• Susan Whang
• Nancy L. Whitcomb, MSW, LICSW
• Alexis Williams
• Allyson Wilson, M.A.,CCC-SLP
• Susan M Winters, PTA
• Giovanna Maria Witowski, RPH, CDM
• Molly K Woodbury, OTR-L MS

• Mental Health Clinic/Center (Including Community Mental Health Center) in Shrewsbury, MA
• Providers in Shrewsbury, MA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.