Individual provider Active NPI

Kelvin Hazangwi

  • Clinical Social Worker
  • Williston, ND
National Provider Identifier
1013620624
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6439 Issued in ND
Practice address
316 2ND Ave W
Williston, ND 58801-5218
Phone
(701) 774-4600
NPI assigned
Dec 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6439 ND Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

316 2ND Ave W
Williston, ND 58801-5218

Mailing address

316 2ND Ave W
Williston, ND 58801-5218
Phone (701) 774-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260407002088 ND Practitioner - Clinical Social Worker 2961977921 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

600 E Boulevard Ave Dept
Suite 325
Bismarck, ND 58505-0602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6439NDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Badlands Behavioral Health Clinic CurrentSince Jan 1, 2023 Accepting new patients
Badlands Behavioral Health Clinic PastSince Jan 1, 2023 Accepting new patients

Locations

1463 I94 Business Loop E
Dickinson, ND 58601
Phone (701) 227-7500

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1013620624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 2ND AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015218",
            "telephone_number": "701-774-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 2ND AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015218",
            "telephone_number": "701-774-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZANGWI",
        "first_name": "KELVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-28",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "6439",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

Verify at the official NPI Registry.