Active NPI
Jaryn Lynn Allen, PH.D., LP
- Counseling Psychologist
- Fargo, ND
National Provider Identifier
1003300187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 528
- Practice address
- 4733 Amber Valley Pkwy S Ste W
Fargo, ND 58104-8647 - Phone
- (701) 368-7400
- NPI assigned
- Jun 21, 2018
- Last updated
- Jun 21, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 528 | ND | Primary |
Addresses
Primary practice location
4733 Amber Valley Pkwy S Ste W
Fargo, ND 58104-8647
Mailing address
4733 Amber Valley Pkwy S Ste W
Fargo, ND 58104-8647
Phone (701) 368-7400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 528 | ND | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529539200000",
"number": "1003300187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4733 AMBER VALLEY PKWY S STE W",
"city": "FARGO",
"state": "ND",
"postal_code": "581048647",
"telephone_number": "701-368-7400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4733 AMBER VALLEY PKWY S STE W",
"city": "FARGO",
"state": "ND",
"postal_code": "581048647",
"telephone_number": "701-368-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "JARYN",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PH.D., LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-21",
"last_updated": "2018-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "ND",
"license": "528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.