=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679110761
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROOM TO GROW THERAPY AND CONSULTING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2019
-----------------------------------------------------
Last Update Date | 05/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 40 MAPLE AVE N
-----------------------------------------------------
City | ANNANDALE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55302-9301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-281-6800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 40 MAPLE AVE N
-----------------------------------------------------
City | ANNANDALE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55302-9301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-281-6800
-----------------------------------------------------
Fax | 320-281-6800
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER
-----------------------------------------------------
Name | STEVEN LOCHEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 320-281-6800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------