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Online Contact Request
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www.AuthenticRootsTherapy.com
7077 Northland Circle N.
Suite 330
Minneapolis, MN 55418
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Email
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Your email
Name (first and last)
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Your answer
Date of Birth
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Phone
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Your answer
Address
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Your answer
Preferred Therapist (feel free to submit multiple forms for different providers)
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Neko Vanevenhoven, MA, LMFT - Therapist, Managing Partner, Supervisor
Amanda Wirth, MA, LMFT - Therapist, Managing Partner, Supervisor
Amy Senapatiratne, MA, LMFT - Therapist, Managing Partner, Supervisor
Doug Robinson, MA, LMFT - Therapist
Sonia Mayren, MA - Therapist
Heidi Sporre, MA - Therapist
Katelyn McMahon, MA - Therapist
Pamela McGowan, BSN, Clinical Trainee Therapist
Christina Franklin, PhD, LP - Psychologist & Therapist
George Baltazar, MA, LADC
Troy Bennett, BS, Clinical Trainee Therapist
Danika McCarthy, BA, Clinical Trainee
Alyson Ash, BA, Clinical Trainee
Emily Charakas, BA, Clinical Trainee
Female Therapist
Male Therapist
Telehealth(video) or In-Person
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Telehealth Only
In-Person Only
Open to Telehealth and In-Person
What specifically are you looking to work on?
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How did you hear about Authentic Roots Therapy?
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How will you be paying?
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Insurance
Private Cash Pay ($150)
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