30:17 COUNSELING (NPI# 1225414956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225414956 |
| Entity Type | Organization |
| Organization Name | 30:17 COUNSELING |
| Practice Address |
1751 Main Ave E West Fargo ND 58078-2203 |
| Practice Telephone | 7015410313 |
| Mailing Telephone | 7015410313 |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-08-04 |
| Authorized Official Name | JOHN GABRIEL PEREZ (PROFESSIONAL CLINICAL COUNSELOR) |
| Authorized Official Telephone | 7015410313 |
| Authorized Official Credential | LPCC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
666-9-1-10-243 | ND | Ambulatory Health Care Facilities |
| Street Address |
1751 MAIN AVE E |
| City | WEST FARGO |
| State | ND |
| Zip Code | 58078-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205068 | Ashley Kasson Therapy | Counselor | 3220 4th St E, West Fargo, ND 58078 | 2020-11-04 |
| 1427658624 | Deedee (dorin) Ngwe | Technician | 3240 9th S West Apt. 204, West Fargo, ND 58078 | 2020-10-27 |
| 1053879734 | Mpnd,inc | Pharmacy | 2050 Sheyenne Street, West Fargo, ND 58078 | 2019-03-12 |
| 1396239216 | Luke Gable | Behavior Technician | 647 13th Avenue South, West Fargo, ND 58078 | 2018-06-15 |
| 1629597919 | Cody Freng | Specialist/Technologist | 3276 9th St W Apt C, West Fargo, ND 58078 | 2017-09-18 |
| 1831613942 | Lauren Phyllis Loe | Physical Therapist | 1401 13th Avenue East, Essentia Health West Fargo Clinic, West Fargo, ND 58078 | 2017-07-31 |
| 1851746226 | Jodi Kilen | Occupational Therapy Assistant | 631 4th Ave East, West Fargo, ND 58078 | 2016-05-04 |
| 1922490101 | Betty Ann Helmer | Social Worker | 2355 Meadow Ridge Parkway, West Fargo, ND 58078 | 2015-02-25 |
| 1477972784 | Tessa Nicole Larson | Occupational Therapist | 3139 Bluestem Dr Ste 108, West Fargo, ND 58078 | 2014-04-15 |
| 1023432010 | Kaylyn Kortes | Licensed Practical Nurse | 1302 Sheyenne St, West Fargo, ND 58078 | 2014-02-11 |
| Find all providers in zip 58078 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922626456 | Tess R Johnson, Pllc | Clinic/Center | 579 River Drive, Dickinson, ND 58601 | 2020-07-10 |
| 1609492016 | Igniting Your Change | Clinic/Center | 1222 4th Ave N Apt 318, Fargo, ND 58102-4374 | 2020-06-22 |
| 1922636323 | Peace of Mind Counseling, Pllc | Clinic/Center | 8351 Palomino Dr, Bismarck, ND 58504-4044 | 2020-03-31 |
| 1093295859 | Healing Hearts Therapy, LLC | Clinic/Center | 511 2nd St W, Williston, ND 58801-5907 | 2018-08-20 |
| 1801337415 | Selah Counseling | Clinic/Center | 125 Main St, Suite #220, Williston, ND 58801 | 2017-03-15 |
| 1043451370 | Sacajawea Substance Abuse Counseling and Drug Testing Center | Clinic/Center | 112 3rd Street West, Suite 301, Dickinson, ND 58601 | 2009-03-17 |
| 1265658967 | Center for Self-growth & Renewal, PC | Clinic/Center | 1551 28th Ave S, Suite C, Grand Forks, ND 58201-6782 | 2007-04-18 |
| 1205932233 | Heart River Alcohol and Drug Abuse Services Inc. | Clinic/Center | 24 W Villard St Ste B, Dickinson, ND 58601-5152 | 2006-09-16 |
| 1588694392 | The Village Family Service Centere | Clinic/Center | 20 1st St Sw, Minot, ND 58701-3851 | 2006-07-04 |
| 1770524613 | Northwest Human Service Center | Clinic/Center | 316 2nd Ave W, Williston, ND 58801-5218 | 2006-06-10 |
| Find all providers with the same taxonomy | ||||
| City | WEST FARGO |
| Zip Code | 58078 |
Please comment or provide details below to improve the information on 30:17 COUNSELING.
| 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.