Deep Roots Healing, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

DEEP ROOTS HEALING, PLLC

Doing business as

Deep Roots Healing, PLLC

Practice address

311 S 4TH St Ste 116
Grand Forks, ND 58201-4792

Phone

(701) 620-9876

NPI assigned

Mar 25, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gaudencia Palomo-Burns, LCSWNPI 1215271515

Title

Clinical Social Worker

Phone

(701) 787-1332

Specialties & licenses 2

Addresses

Other names 1

• Deep Roots Healing, PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gaudencia Palomo-Burns, LCSW

  • Clinical Social Worker
  • Grand Forks, ND
  • NPI 1215271515
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1639971203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S 4TH ST STE 116",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014792",
            "telephone_number": "701-620-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S 4TH ST STE 116",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014792",
            "telephone_number": "701-620-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP ROOTS HEALING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "PALOMO-BURNS",
        "authorized_official_first_name": "GAUDENCIA",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "701-787-1332",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deep Roots Healing, PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Deep Roots Healing, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Greg Decker, PH.D.
• Schawnn Marie Decker, PT
• Donovan James Decoteau
• Eric Decoteau
• Melissa Marie Decoteau
• Deere Wellness LLC
• Joshua Richard Deere, MD
• Kylie Deere, LICSW; LCSW
• Kyler Delancey
• Vanessa Delgado-Ramirez, LCSW

• Clinical Social Worker in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.