STACEY NELSON (NPI# 1215346259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215346259 |
| Entity Type | Individual |
| Full Name | STACEY NELSON |
| Credential | LAC |
| Practice Address |
4215 9th Ave S Fargo ND 58103-2018 |
| Practice Telephone | 7013738667 |
| Mailing Telephone | 7013738667 |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-08-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1740 | ND | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922489723 | Stacey D Nelson | Social Worker | 11048 Cardiff Ln, Frisco, TX 75035-6673 | 2015-06-17 |
| 1740546050 | Stacey Nelson | Licensed Practical Nurse | 2634 Pearl St, Detroit, MI 48209-3700 | 2012-04-11 |
| 1609942655 | Stacey Nelson | Social Worker | 4371 E 72nd Ave, Commerce City, CO 80022-1471 | 2006-11-28 |
| 1033293279 | Stacey J Nelson | Marriage & Family Therapist | 1200 N Federal Hwy Ste 200, Boca Raton, FL 33432-2813 | 2006-10-24 |
| 1598204109 | Stacey Nelson | Registered Nurse | 777 Murphy Rd, Medford, OR 97504-8425 | 2017-02-15 |
| 1770839029 | Stacey Nelson | Registered Nurse | 1704 E Broadway Ave, Maryville, TN 37804 | 2012-07-24 |
| 1225384589 | Stacey White Nelson | Counselor | 1307 E Elm St, Athens, AL 35611-5318 | 2012-07-24 |
| 1760790828 | Stacey Lynn Nelson | Psychologist | 11280 86th Ave N, Maple Grove, MN 55369-4510 | 2010-09-22 |
| 1912187329 | Stacey Lynn Nelson | Nurse Anesthetist, Certified Registered | 77 W Forest Ave Ste 117, Flagstaff, AZ 86001-1482 | 2007-11-14 |
| 1538292834 | Stacey Nelson | Counselor | 914 E Broadway, Louisville, KY 40204-1037 | 2007-03-14 |
| Street Address |
4215 9TH AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-2018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245784156 | Bryan Allen Bloemendaal | Counselor | 4215 9th Ave S, Fargo, ND 58103-2018 | 2016-08-09 |
| 1437530391 | Paul Vigen | Counselor | 4215 9th Ave S, Fargo, ND 58103-2018 | 2015-06-16 |
| 1437537602 | Sharehouse, Inc | Substance Abuse Rehabilitation Facility | 4215 9th Ave S, Fargo, ND 58103-2018 | 2015-05-08 |
| 1831576271 | Timothy Clark | Counselor | 4215 9th Ave S, Fargo, ND 58103-2018 | 2015-05-06 |
| 1285032052 | Kendra Wilson | Counselor | 4215 9th Ave S, Fargo, ND 58103-2018 | 2014-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991406 | N.i.a.m Brain Injury Services, LLP | Counselor | 1206 1st Ave S, Fargo, ND 58103-1747 | 2020-01-20 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1205360153 | Community Medical Services Montana-private, LLC | Counselor | 901 28th St S Ste B, Fargo, ND 58103-8743 | 2017-04-18 |
| 1962805317 | Lisa Vig | Counselor | 4720 7th Ave S Ste B, Fargo, ND 58103-7254 | 2014-09-30 |
| 1649689506 | Cara Christenson | Counselor | 505 40th St S, Suite B, Fargo, ND 58103-1184 | 2014-08-05 |
| 1508273418 | Robert Hansen | Counselor | 1202 23rd St S Ste 5, Fargo, ND 58103-2951 | 2014-07-14 |
| 1326469883 | Community Extended Nuclear Transitional Residence for Ex-offenders | Counselor | 123 15th St N, Fargo, ND 58102-4220 | 2013-12-30 |
| 1760765416 | Roberta J Pytlik | Counselor | 17 7th St S, Fargo, ND 58103-1800 | 2011-09-20 |
| 1891934873 | Paulette L Walker | Counselor | 1121 Westrac Dr S Ste 202, Fargo, ND 58103-2385 | 2009-02-13 |
| 1609025659 | Jill M Lavelle | Counselor | 1445 1st Ave N, Fargo, ND 58102 | 2008-09-15 |
| Find all providers in FARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.