Provider Demographics
NPI:1376428102
Name:KINDROOT THERAPY, PLLC
Entity type:Organization
Organization Name:KINDROOT THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEAFSTEDT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MH
Authorized Official - Phone:605-400-3776
Mailing Address - Street 1:614 W WILLOW ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57032-2619
Mailing Address - Country:US
Mailing Address - Phone:605-400-3776
Mailing Address - Fax:605-443-9587
Practice Address - Street 1:401 E 8TH ST STE 214-9009
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-7011
Practice Address - Country:US
Practice Address - Phone:605-443-9586
Practice Address - Fax:605-443-9587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1760806053Medicaid