Healthcare Provider Details
I. General information
NPI: 1841007820
Provider Name (Legal Business Name): FINDING GROUND THERAPEUTIC WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2024
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3523 45TH ST S STE 100
FARGO ND
58104-8962
US
IV. Provider business mailing address
3523 45TH ST S STE 100
FARGO ND
58104-8962
US
V. Phone/Fax
- Phone: 701-394-5313
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
LARISSA
JANE
MARSH
Title or Position: OWNER
Credential: LCSW, LICSW
Phone: 701-260-4021