MEDICARE: JAMIE ROSE ST CLAIRE MSW, LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	35236	MN
2	104100000X	Social Worker	6480	ND

General Provider Information

NPI Number	:	1922971993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE ROSE ST CLAIRE MSW, LMSW

Provider Business Mailing Address
First Line	:	2454 CUMBERLAND RD
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58201-6125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1913 S WASHINGTON ST STE C
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58201-6339
Country	:	US
Telephone Number	:	701-757-1425
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2025
Last Update Date	:	09/25/2025

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