MRS. AMANDA RAE HAIRE (NPI# 1952686347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952686347 |
| Entity Type | Individual |
| Full Name | MRS. AMANDA RAE HAIRE |
| Credential | LAMFT |
| Practice Address |
2624 9th Ave S Southeast Hsc Fargo ND 58103 |
| Practice Telephone | 7012984500 |
| Practice Fax Number | 7012984400 |
| Mailing Telephone | 7012984500 |
| Mailing Fax Number | 7012984400 |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2011-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 2011005A | ND | Behavioral Health & Social Service Providers |
| Street Address |
2624 9TH AVE S SOUTHEAST HSC |
| City | FARGO |
| State | ND |
| Zip Code | 58103 |
| 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 | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730566035 | Julie Windahl I | Marriage & Family Therapist | 4955 17th Ave S Ste 122, Fargo, ND 58103-3372 | 2015-05-06 |
| 1073751343 | William Noel Ahlfeldt | Marriage & Family Therapist | 102 25th Ave N, Fargo, ND 58102-2039 | 2009-01-26 |
| 1336307198 | Winnie A Austin | Marriage & Family Therapist | 461 34th St S Ste B, Fargo, ND 58103 | 2008-05-29 |
| 1013126325 | Cynthia Johnson | Marriage & Family Therapist | 3309 Fiechtner Dr. S. Ste H, Fargo, ND 58103 | 2007-05-22 |
| 1982822276 | Sarah Lynne Stigen | Marriage & Family Therapist | 509 25th Ave N, Fargo, ND 58102-1938 | 2007-04-23 |
| 1245312149 | Elizabeth A Luft | Marriage & Family Therapist | 26 Roberts St N, Ste 114-a, Fargo, ND 58102-5200 | 2006-10-19 |
| 1154896314 | Amanda Bulat | Marriage & Family Therapist | 1202 Westrac Dr S Ste 100, Fargo, ND 58103-2356 | 2018-10-03 |
| 1417490160 | Katrina Kanwischer | Marriage & Family Therapist | 1126 Westrac Dr S, Fargo, ND 58103-2473 | 2016-11-29 |
| 1497203988 | Bethany Peterson | Marriage & Family Therapist | 1201 25th St S, Fargo, ND 58103-2311 | 2016-09-14 |
| 1073975199 | Victoria Zak | Marriage & Family Therapist | 2624 9th Ave S, Fargo, ND 58103-2350 | 2016-03-28 |
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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.