| St. Sophie's, Llc | |
|
3201 33rd St S Fargo ND 58104-8823 | |
| (701) 365-4488 | |
| (701) 365-0727 |
| Full Name | St. Sophie's, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3201 33rd St S, Fargo, North Dakota |
| Authorized Official Name and Position | Tracey Jean Frei (OFFICE MANAGER) |
| Authorized Official Contact | 7013654467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Sophie's, Llc 3201 33rd St S Fargo ND 58104-8823 Ph: (701) 365-4488 | St. Sophie's, Llc 3201 33rd St S Fargo ND 58104-8823 Ph: (701) 365-4488 |
| NPI Number | 1336443654 |
|---|---|
| Provider Enumeration Date | 12/29/2010 |
| Last Update Date | 04/30/2014 |
| Medicare PECOS PAC ID | 7113195074 |
|---|---|
| Medicare Enrollment ID | O20110719000878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336443654 | NPI | - | NPPES |
| 15685 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 7174 (North Dakota) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 7174 (North Dakota) | Primary |
| Provider Name | Emmet M Kenney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902998081 PECOS PAC ID: 9436140670 Enrollment ID: I20040518001264 |
| Provider Name | Randy Swingen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861637852 PECOS PAC ID: 5597829481 Enrollment ID: I20090121000219 |
| Provider Name | Aminata Kamara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578127288 PECOS PAC ID: 2062844863 Enrollment ID: I20191116000408 |
| Provider Name | Rachel A Sauter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134781321 PECOS PAC ID: 9335572700 Enrollment ID: I20191126001403 |
| Provider Name | Stephanie Akers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609443597 PECOS PAC ID: 3274916473 Enrollment ID: I20220822001632 |
| Provider Name | Thomas Ugelstad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285373738 PECOS PAC ID: 4486024411 Enrollment ID: I20230106002692 |
| Provider Name | Justine Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770329203 PECOS PAC ID: 5991239766 Enrollment ID: I20241115002196 |
| Provider Name | Andrea Okerstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689352056 PECOS PAC ID: 8729514591 Enrollment ID: I20241204002249 |
Insight Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1330 Page Dr S Ste 202a, Fargo, ND 58103 Phone: 701-367-5985 Fax: 701-353-2080 | |
Optimal Behavioral Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3523 45th St S Ste 100, Fargo, ND 58104 Phone: 602-430-9646 | |
Carita R Shawchuck, Phd, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1121 Westrac Dr S Ste 204, Fargo, ND 58103 Phone: 701-893-3419 Fax: 701-356-8801 | |
Fraser, Ltd. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2902 University Dr S, Fargo, ND 58103 Phone: 701-232-3301 Fax: 701-237-5775 | |
Sanford Clinic North Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 1st Ave S, Fargo, ND 58103 Phone: 701-234-4036 Fax: 701-234-4134 | |
Shanti Wellness Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3481 University Dr S Ste 104, Fargo, ND 58104 Phone: 701-353-9238 Fax: 701-205-1221 | |
Path Minnesota, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 Westrac Dr S Ste 400, Fargo, ND 58103 Phone: 701-280-9545 Fax: 701-451-9473 |