SOUTHEAST HUMAN SERVICE CENTER (NPI# 1295256386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295256386 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST HUMAN SERVICE CENTER |
| Practice Address |
2624 9th Ave S Fargo ND 58103-2350 |
| Practice Telephone | (701) 298-4500 |
| Practice Fax Number | 7012984400 |
| Mailing Telephone | 7012984500 |
| Mailing Fax Number | 7012984400 |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2017-06-29 |
| Authorized Official Name | STENSETH JEFF (DIRECTOR) |
| Authorized Official Telephone | 7013284578 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | ND249518 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245284850 | Southeast Human Service Center | Clinic/Center | 2624 9th Ave S, Fargo, ND 58103-2350 | 2006-05-19 |
| 1932146941 | Southeast Human Service Center | Clinic/Center | 2624 9th Ave S, Fargo, ND 58103-2350 | 2006-05-31 |
| 1922055243 | Southeast Human Service Center | Day Training, Developmentally Disabled Services | 2624 9th Ave S, Fargo, ND 58103-2350 | 2006-05-30 |
| Street Address |
2624 9TH AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-2350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245284850 | Southeast Human Service Center | Clinic/Center | 2624 9th Ave S, Fargo, ND 58103-2350 | 2006-05-19 |
| 1750982120 | Lena Fogel | Counselor | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-11-03 |
| 1356956247 | Carmen Berg | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-09-09 |
| 1225643125 | Heidi Ottmar | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-09-09 |
| 1962011239 | Tayler Wilson | Registered Nurse | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-07-23 |
| 1023626595 | Jordan Solheim | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-07-21 |
| 1710595954 | Carissa Bertsch | Registered Nurse | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-07-14 |
| 1740898923 | Madeline Swanson | Social Worker | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-07-14 |
| 1821615394 | Tanner Valnes | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-07-01 |
| 1447876446 | Rachael Steinke | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-06-25 |
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| 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 | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061505 | Fraser, Ltd | Community/Behavioral Health | 1621 34th St S, Fargo, ND 58103-8413 | 2020-10-21 |
| 1427657469 | Fraser, Ltd | Community/Behavioral Health | 514 University Dr S, Fargo, ND 58103-2648 | 2020-10-21 |
| 1083213045 | Fraser, Ltd | Community/Behavioral Health | 717 University Dr S, Fargo, ND 58103-2679 | 2020-10-21 |
| 1912506809 | Fraser, Ltd | Community/Behavioral Health | 4311 9th Avenue Cir S, Fargo, ND 58103-7081 | 2020-10-21 |
| 1912506213 | Fraser, Ltd | Community/Behavioral Health | 3585 58th Ct S, Fargo, ND 58104-7344 | 2020-10-19 |
| 1588261440 | Vocational Training Center, Inc. | Community/Behavioral Health | 424 9th Ave S, Fargo, ND 58103-2831 | 2020-10-05 |
| 1861054637 | Encompass Family Support Services | Community/Behavioral Health | 320 5th St N, Fargo, ND 58102-4815 | 2019-07-02 |
| 1811437916 | Clarity Counseling, Pllc | Community/Behavioral Health | 808 3rd Ave S, Ste 303, Fargo, ND 58103-1865 | 2017-03-08 |
| 1275088619 | Journey Counseling Pllc | Community/Behavioral Health | 222 Broadway N Ste 206, Fargo, ND 58102-4770 | 2016-08-15 |
| 1235412388 | Sharehouse Mental Health Clinic | Community/Behavioral Health | 505 40th St S Unit A, Fargo, ND 58103-1184 | 2011-09-26 |
| 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.