Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Revive Roots, PLLC

Organization Community/Behavioral Health Agency · NPI 1548800915

Revive Roots, PLLC is a Community/Behavioral Health Agency in Minneapolis, Minnesota. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3440 Portland Ave
Minneapolis, MN 55407-4861
Phone: (612) 990-8172
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
Community/Behavioral Health Agency Taxonomy 251S00000X

Record details

NPI number1548800915
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marlee Dorsey — President · (612) 445-7781
Other names Reviving Roots Therapy & Wellness; Reviving Roots Therapy & Wellness
NPI enumeratedJanuary 13, 2020
Last updated in NPPESSeptember 24, 2020
Certification dateSeptember 24, 2020
Mailing address3440 Portland Ave, Minneapolis, MN 55407-4861

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