Healthcare Provider Details

I. General information

NPI: 1356928741
Provider Name (Legal Business Name): CALM THERAPY PLACE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 BURDICK EXPY W STE C
MINOT ND
58701-5667
US

IV. Provider business mailing address

1821 BURDICK EXPY W STE C
MINOT ND
58701-5667
US

V. Phone/Fax

Practice location:
  • Phone: 701-852-7171
  • Fax: 701-852-7121
Mailing address:
  • Phone: 701-852-7171
  • Fax: 701-852-7121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical 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: MS. ROCHELLE RENEE NYBERG
Title or Position: AUTHORIZED OFFICIAL/OWNER
Credential: LCSW
Phone: 701-852-7171