LISA MARIE HOLTER (NPI# 1366860520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366860520 |
| Entity Type | Individual |
| Full Name | LISA MARIE HOLTER |
| Credential | LPCC |
| Practice Address |
3911 20th Ave S Fargo ND 58103-4705 |
| Practice Telephone | 7012711613 |
| Practice Fax Number | 7012357359 |
| Mailing Telephone | 7012711613 |
| Mailing Fax Number | 7012357359 |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2019-09-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
721-7-15-12A | ND | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 78033 | 05 | |
| ND | ND MEDICAID | 1457643 | 01 |
| Street Address |
3911 20TH AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-4705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811083173 | Glenda G Trochmann | Social Worker | 3911 20th Ave S, Fargo, ND 58103-4705 | 2006-10-05 |
| 1871190793 | Toby Farrenkopf | Social Worker | 3911 20th Ave S, Fargo, ND 58103-4705 | 2020-10-04 |
| 1285231241 | Amy Brooks | Social Worker | 3911 20th Ave S, Fargo, ND 58103-4705 | 2020-10-02 |
| 1942807904 | Carmel Froemke | Case Manager/Care Coordinator | 3911 20th Ave S, Fargo, ND 58103-4705 | 2020-10-02 |
| 1336754993 | Heidi Frances Dahmes | Social Worker | 3911 20th Ave S, Fargo, ND 58103-4705 | 2020-09-10 |
| 1710509914 | Amanda Cossette | Social Worker | 3911 20th Ave S, Fargo, ND 58103-4705 | 2020-05-11 |
| 1316569767 | Goetz Mental Wellness Initiative | Clinic/Center | 3911 20th Ave S, Fargo, ND 58103-4705 | 2020-05-08 |
| 1346861432 | Kelsey Moorhouse | Social Worker | 3911 20th Ave S, Fargo, ND 58103-4705 | 2020-04-30 |
| 1982225074 | Hayley Jangula | Social Worker | 3911 20th Ave S, Fargo, ND 58103-4705 | 2020-04-30 |
| 1073134227 | Rebekah Noel Jensen | Social Worker | 3911 20th Ave S, Fargo, ND 58103-4705 | 2020-04-29 |
| Find all providers in the same location | ||||
| 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 | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669079760 | Patricia Bathie Counseling | Counselor | 4243 Auburn Ave, Fargo, ND 58104-8428 | 2020-10-02 |
| 1154950244 | Jeffrey D Bates Lpcc Pllc | Counselor | 1351 Page Dr S Ste 103, Fargo, ND 58103-3536 | 2020-04-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1851944680 | Chloe Krinke | Counselor | 4357 13th Ave S Ste 211, Fargo, ND 58103-7506 | 2019-07-21 |
| 1174006639 | Erin R Hagen | Counselor | 26 Roberts St N Ste 114, Fargo, ND 58102-5200 | 2018-09-11 |
| 1376090365 | Jeffrey Bates | Counselor | 4141 31st Ave S Ste 102, Fargo, ND 58104-8778 | 2016-09-07 |
| 1306227459 | Farryn Helm | Counselor | 1330 Page Dr S Ste 102a, Fargo, ND 58103-3562 | 2015-06-15 |
| 1518391192 | Gail N Reierson | Counselor | 2524 18th St S, Fargo, ND 58103-6602 | 2013-08-30 |
| 1588974018 | Debra K Deminck | Counselor | 3105 Elm St N, Fargo, ND 58102-1740 | 2010-10-18 |
| 1437460987 | Darrin Tonsfeldt | Counselor | 417 Main Ave Ste 302, Fargo, ND 58103-1956 | 2010-06-30 |
| 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.