Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicodemus Therapeutic Services PLLC

Organization Clinical Social Worker · NPI 1063113108

Nicodemus Therapeutic Services PLLC is a Clinical Social Worker in Minot, North Dakota. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

525 31st Ave SW
Minot, ND 58701-7036
Phone: (701) 355-6800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1063113108
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Starks — Therapist · (701) 500-5430
NPI enumeratedMarch 15, 2023
Last updated in NPPESDecember 13, 2023
Certification dateDecember 12, 2023
Mailing address525 31st Ave Sw, Minot, ND 58701-7036

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