Local City Search for Psychiatrists, Psychologists, Therapists, Counselors and Mental Health Treatment CentersSANFORD CLINIC NORTH
Clinical Neuropsychologist
Fargo, North Dakota
Provider NPI: 1023030046
Organization Information:Organization Name: SANFORD CLINIC NORTH
Organization is not Subpart
Authorized Official: MARTHA K LECLERC VP 701-2346248
Practice Location:
700 1ST AVE S FARGO, ND 58103 US
Tel: 701-234-4036 Fax: 701-234-4134
Business Mailing Address:
700 1ST AVE S FARGO, ND 58103 US
Tel: 701-234-4036 Fax: 701-234-4134
Entity Type: Organization
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Organization is not Subpart
Authorized Official: MARTHA K LECLERC VP 701-2346248
Practice Location:
700 1ST AVE S FARGO, ND 58103 US
Tel: 701-234-4036 Fax: 701-234-4134
Business Mailing Address:
700 1ST AVE S FARGO, ND 58103 US
Tel: 701-234-4036 Fax: 701-234-4134
Entity Type: Organization
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | ||
| N | 103T00000X | Behavioral Health & Social Service Providers Psychologist | ||
| N | 207T00000X | Physicians Neurological Surgery | ||
| N | 2084N0400X | Physicians Psychiatry & Neurology | ||
| N | 2084P0800X | Physicians Psychiatry & Neurology |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 648513800 | MN | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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