DR. BRIAN KEITH MOE (NPI# 1396048518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396048518 |
| Entity Type | Individual |
| Full Name | DR. BRIAN KEITH MOE |
| Credential | PH.D. |
| Practice Address |
2624 9th Ave S Fargo ND 58103-2350 |
| Mailing Address |
1563 11th Ave E West Fargo ND 58078-5204 |
| Practice Telephone | 7012984500 |
| Mailing Telephone | 2187790230 |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2013-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 480 | ND | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609966035 | Brian D Moe | Pharmacist | 3327 44th Ave S, Fargo, ND 58104-6643 | 2006-10-14 |
| 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 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366067084 | Minela Zornic | Psychologist | 204 24th St S Apt 210, Fargo, ND 58103-1350 | 2020-06-09 |
| 1518240332 | Erica R Hoff | Psychologist | 505 40th St. S., Suite 505a, Fargo, ND 58103 | 2011-09-28 |
| 1538399019 | Kristilynn Cedars | Psychologist | 5225 23rd Ave S Route 4712, Fargo, ND 58122-4712 | 2009-07-20 |
| 1982707543 | David Jerome Hartson | Psychologist | 1517 32nd Ave S, Fargo, ND 58103-5905 | 2006-09-07 |
| 1255449989 | Sara D Quam | Psychologist | 3220 18th St S, Ste 4, Fargo, ND 58104-6564 | 2006-08-25 |
| 1114949773 | Eileen Stone | Psychologist | 1308 23rd St S, Fargo, ND 58103 | 2006-07-24 |
| 1215982319 | Jackson William Lind | Psychologist | 100 4th St. S #302, Fargo, ND 58103 | 2006-05-24 |
| 1720622822 | Nicole Marie Justice | Psychologist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-10-31 |
| 1386186211 | Katie Nylander | Psychologist | 3401 45th St S, Fargo, ND 58104 | 2016-11-09 |
| 1770930273 | Megan L Spencer | Psychologist | 1702 University Dr S, Fargo, ND 58103-4940 | 2016-05-16 |
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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.