| Stage Of Change Therapy Pllc | |
|
4200 James Dr # 305 Grand Forks ND 58202 | |
| (701) 213-6999 | |
| Not Available |
| Full Name | Stage Of Change Therapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4200 James Dr # 305, Grand Forks, North Dakota |
| Authorized Official Name and Position | Adam Nygaard (LCSW/OWNER) |
| Authorized Official Contact | 7012136999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stage Of Change Therapy Pllc 4200 James Dr # 305 Grand Forks ND 58202 Ph: (701) 213-6999 | Stage Of Change Therapy Pllc 4200 James Dr # 305 Grand Forks ND 58202 Ph: (701) 213-6999 |
| NPI Number | 1003627506 |
|---|---|
| Provider Enumeration Date | 01/15/2025 |
| Last Update Date | 01/15/2025 |
| Certification Date | 01/13/2025 |
| Medicare PECOS PAC ID | 0244753713 |
|---|---|
| Medicare Enrollment ID | O20250326001280 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003627506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Adam Nygaard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912214719 PECOS PAC ID: 0345783619 Enrollment ID: I20240614004070 |
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