| Devils Lake Psychological Services, Pllc | |
|
218 4th St Nw Ste 1 Devils Lake ND 58301-2930 | |
| (701) 662-8255 | |
| (701) 662-1739 |
| Full Name | Devils Lake Psychological Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 218 4th St Nw Ste 1, Devils Lake, North Dakota |
| Authorized Official Name and Position | Jennifer Hoffarth (CLINICAL PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 7016628255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Devils Lake Psychological Services, Pllc 218 4th St Nw Ste 1 Devils Lake ND 58301-2930 Ph: (701) 662-8255 | Devils Lake Psychological Services, Pllc 218 4th St Nw Ste 1 Devils Lake ND 58301-2930 Ph: (701) 662-8255 |
| NPI Number | 1023598083 |
|---|---|
| Provider Enumeration Date | 08/20/2018 |
| Last Update Date | 08/01/2023 |
| Certification Date | 08/01/2023 |
| Medicare PECOS PAC ID | 2163773896 |
|---|---|
| Medicare Enrollment ID | O20180919003182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023598083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer J Hoffarth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790163566 PECOS PAC ID: 4082925342 Enrollment ID: I20150612002345 |
| Provider Name | Jocelyn R Soderstrom |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740789684 PECOS PAC ID: 8921360884 Enrollment ID: I20180313001782 |
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