Jacqueline Stanford-Rodriguez
Individual provider Active NPI Case Manager/Care Coordinator · Fargo, ND
NPI 1003635665 · NPPES record last updated Oct 9, 2024
Key facts
- NPI
- 1003635665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- 00000 (ND)
- Practice address
- 417 Main Ave Ste 401
Fargo, ND 58103-1956 - Phone
- (936) 223-1470
- NPI assigned
- Oct 9, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00000 | ND | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Uplift Program | Current |
Accepting new patients | |
| Advocates for Change | Current |
Accepting new patients |
Locations
417 Main Ave
Ste 401
Fargo, ND 58103
Phone (701) 289-7676
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 00000 | ND | Yes |
Addresses
Primary practice location
417 Main Ave Ste 401
Fargo, ND 58103-1956
Mailing address
417 Main Ave Ste 401
Fargo, ND 58103-1956
Phone (936) 223-1470
Other providers in Fargo, ND
- Sandra Stalemo
- Stalina
- Donald J Stallman
- Stand
- Standing Tall Recovery & Consulting LLC
- Sonja Nicole Stang
- Devaroux Stanga
- Marsha Stangler
- Cody Benard Stanley
- Haley Holland Stanley
All providers in Fargo, ND · Case Manager/Care Coordinator in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.