MS. JILL M LAVELLE (NPI# 1609025659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609025659 |
| Entity Type | Individual |
| Full Name | MS. JILL M LAVELLE |
| Credential | M.ED. LAC |
| Practice Address |
1445 1st Ave N Fargo ND 58102 |
| Practice Telephone | 7012613113 |
| Practice Fax Number | 7012983497 |
| Mailing Telephone | 7012613113 |
| Mailing Fax Number | 7012983496 |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2008-09-15 |
| 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) |
ND1439 | ND | Behavioral Health & Social Service Providers |
| Street Address |
1445 1ST AVE N |
| City | FARGO |
| State | ND |
| Zip Code | 58102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| 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 |
| 1215346259 | Stacey Nelson | Counselor | 4215 9th Ave S, Fargo, ND 58103-2018 | 2014-08-04 |
| 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 |
| 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.