| Minot Dakota Family Services | |
|
600 22nd Ave Nw Minot ND 58703-0986 | |
| (701) 837-6508 | |
| (701) 858-1839 |
| Full Name | Minot Dakota Family Services |
|---|---|
| Speciality | Counselor |
| Location | 600 22nd Ave Nw, Minot, North Dakota |
| Authorized Official Name and Position | Connie F Irey (OFFICE MANAGER) |
| Authorized Official Contact | 7018376508 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minot Dakota Family Services Po Box 1148 Minot ND 58702-1148 Ph: (701) 837-6508 | Minot Dakota Family Services 600 22nd Ave Nw Minot ND 58703-0986 Ph: (701) 837-6508 |
| NPI Number | 1114119989 |
|---|---|
| Provider Enumeration Date | 08/15/2007 |
| Last Update Date | 08/15/2007 |
| Medicare PECOS PAC ID | 9335232198 |
|---|---|
| Medicare Enrollment ID | O20070910000835 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114119989 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Wayne L Martinsen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851352504 PECOS PAC ID: 5092744888 Enrollment ID: I20050811000684 |
| Provider Name | Meryl G Willert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346210499 PECOS PAC ID: 8729171517 Enrollment ID: I20070911000008 |
| Provider Name | Christy R Wilkie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538259411 PECOS PAC ID: 5991898785 Enrollment ID: I20070911000020 |
| Provider Name | Tammy L Uleberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710051628 PECOS PAC ID: 5395880686 Enrollment ID: I20100311000492 |
| Provider Name | Megan Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770930273 PECOS PAC ID: 3779875737 Enrollment ID: I20160712001503 |
| Provider Name | Vanessa Elaine Coulter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609227909 PECOS PAC ID: 4385930171 Enrollment ID: I20160902000945 |
| Provider Name | Sandra J Richter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417310731 PECOS PAC ID: 7214267145 Enrollment ID: I20190919001061 |
| Provider Name | Lucas Mitzel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336795640 PECOS PAC ID: 0143632786 Enrollment ID: I20201223001941 |
| Provider Name | Falan Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992399919 PECOS PAC ID: 9638585441 Enrollment ID: I20210302002606 |
| Provider Name | April Marie Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407166150 PECOS PAC ID: 8527467489 Enrollment ID: I20210525002928 |
| Provider Name | Hannah Baczynski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487191433 PECOS PAC ID: 6709169006 Enrollment ID: I20211029001257 |
| Provider Name | Jessica Mertz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548530280 PECOS PAC ID: 3274779988 Enrollment ID: I20221005003118 |
| Provider Name | Amanda Daggett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174298178 PECOS PAC ID: 7618343237 Enrollment ID: I20221021000971 |
| Provider Name | Jesse Albert Lamm |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407361421 PECOS PAC ID: 3678967718 Enrollment ID: I20240126000832 |
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