Healthcare Provider Details

I. General information

NPI: 1942119854
Provider Name (Legal Business Name): ROOM TO GROW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 S BROADWAY STE 38
MINOT ND
58701-4667
US

IV. Provider business mailing address

81 MULBERRY LOOP NE
MINOT ND
58703-0570
US

V. Phone/Fax

Practice location:
  • Phone: 701-347-1171
  • Fax:
Mailing address:
  • Phone: 701-347-1171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JESSICA MCCAY
Title or Position: LCSW
Credential:
Phone: 701-347-1171