Provider Demographics
NPI:1356928741
Name:CALM THERAPY PLACE, PLLC
Entity type:Organization
Organization Name:CALM THERAPY PLACE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:NYBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:701-852-7171
Mailing Address - Street 1:1821 BURDICK EXPY W STE C
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-5667
Mailing Address - Country:US
Mailing Address - Phone:701-852-7171
Mailing Address - Fax:701-852-7121
Practice Address - Street 1:1821 BURDICK EXPY W STE C
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-5667
Practice Address - Country:US
Practice Address - Phone:701-852-7171
Practice Address - Fax:701-852-7121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty