Cynthia Johnson
Individual provider Active NPI Marriage & Family Therapist · Fargo, ND
NPI 1013126325 · NPPES record last updated Jun 26, 2018
Key facts
- NPI
- 1013126325
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 321-81-9542 (ND)
- Practice address
- 3309 Fiechtner Dr. S. Ste H
Fargo, ND 58103 - Phone
- (218) 329-3552
- Fax
- (701) 403-8003
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1993
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
Vergas, MN 56587
Phone (218) 329-3552
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241118000637 | MN | Practitioner - Mental Health Counselor | 9436683174 | Practice locations: Vergas, MN |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1017 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hansen Hearts Counseling, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 321-81-9542 | ND | Yes |
Addresses
Primary practice location
3309 Fiechtner Dr. S. Ste H
Fargo, ND 58103
Mailing address
3309 Fiechtner Dr. S. Ste H
Fargo, ND 58103
Phone (218) 329-3552
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1462112 | Medicaid | ND |
Other providers in Fargo, ND
- Chase Johnson
- Chloe L Johnson
- Colin James Johnson
- Craig D Johnson
- Cybil Johnson
- Daniel David Johnson
- Denise L Johnson
- Donita Jane Johnson
- Edward R Johnson
- Eldon A. Johnson
All providers in Fargo, ND · Marriage & Family Therapist 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 Jun 26, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.