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DEEP ROOTS HEALING, PLLC
NPI 1639971203
Social Worker - Clinical in Grand Forks, ND

Active since March 25, 2025
311 S 4TH ST STE 116, GRAND FORKS, ND 58201(701) 620-9876 Get Directions Write a Review

NPPES record last updated: April 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 11, 2025, Mar 25, 2025 (2 updates tracked since 2025).

About Deep Roots Healing, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEEP ROOTS HEALING, PLLC (NPI 1639971203) is a healthcare organization registered as a clinical in Grand Forks, North Dakota and active in the NPI registry since March 2025. The organization lists Gaudencia Palomo-burns, Clinical Social Worker, as its authorized official.

NPPES Registry Identity

NPI1639971203
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameDEEP ROOTS HEALING, PLLC
Location Address311 S 4TH ST STE 116Grand Forks, ND 58201-4792
Mailing Address311 S 4th St Ste 116Grand Forks, ND 58201-4792 · (701) 620-9876
Phone(701) 620-9876
Organization SubpartNo
Authorized OfficialGaudencia Palomo-burnsClinical Social Worker · (701) 787-1332
Enumeration DateMarch 25, 2025
Last NPPES UpdateApril 11, 20252 updates tracked since enumeration
NPPES CertifiedApril 11, 2025
✔ NPI 1639971203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedSocial WorkerTaxonomy 104100000X
311 S 4TH ST STE 116, Grand Forks, ND 58201
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Other Names 1

Doing Business AsDeep Roots Healing, Pllc

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Deep Roots Healing, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Deep Roots Healing, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Gaudencia Palomo-Burns, LCSW
Clinical Social Worker
NPI 1215271515
311 S 4TH ST STE 116
Grand Forks, ND 58201
(701) 787-1332
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deep Roots Healing, PLLC's NPI number?

The NPI number for Deep Roots Healing, PLLC is 1639971203. It was assigned to this organization in the NPPES registry on March 25, 2025.

Where is Deep Roots Healing, PLLC located?

Deep Roots Healing, PLLC is located at 311 S 4th St Ste 116, Grand Forks, ND 58201. The listed phone number is (701) 620-9876.

What is Deep Roots Healing, PLLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Deep Roots Healing, PLLC enrolled in Medicare?

Yes. Deep Roots Healing, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Deep Roots Healing, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Deep Roots Healing, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Deep Roots Healing, PLLC accept?

Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list Deep Roots Healing, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Deep Roots Healing, PLLC was last updated on April 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.