Individual provider Active NPI

Ani Celine Mangold, PHD, LP

  • Clinical Psychologist
  • Fargo, ND
National Provider Identifier
1033898762
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
653 Issued in ND
Practice address
1635 43Rd St S Ste 105
Fargo, ND 58103-3579
Phone
(218) 287-4338
NPI assigned
Jul 11, 2023
Last updated
Sep 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X 653 ND Primary
Clinical Child & Adolescent Psychologist 103TC2200X

Addresses

Primary practice location

1635 43Rd St S Ste 105
Fargo, ND 58103-3579

Mailing address

1547 30TH Ave S
Moorhead, MN 56560-5149

Other names 1

  • Dr. Annie Celine Mangold Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231103001198 ND Practitioner - Clinical Psychologist 0345697975 Reassigns benefits to 1 organization
Practice locations: Fargo, ND
I20250707000963 MN Practitioner - Clinical Psychologist 0345697975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solutions Behavioral Healthcare Professionals PCGroup PAC ID 0345209524, 30 clinicians

Practice addresses (Care Compare)

1547 30TH Ave S
Moorhead, MN 56560-5149
Phone (218) 287-4338

1635 43Rd St S
Suite 105
Fargo, ND 58103-3579
Phone (701) 412-2973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
653NDMDMassage Therapist
634NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ani Mangold Psychological Services PLLC CurrentSince Mar 2, 2025 Accepting new patients
Solutions Behavioral Healthcare Professionals, PC Psychologist CurrentSince Apr 28, 2025 Accepting new patients

Locations

1547 30th Ave S
Moorhead, MN 56560
Phone 21828743381113

4503 Coleman St
Ste 203
Bismarck, ND 58503
Phone (701) 412-2973

1635 43rd St S
Ste 105
Fargo, ND 58103
Phone (701) 412-2973

2534 University Dr S
Ste 3
Fargo, ND 58103
Phone (701) 293-0751

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1033898762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 30TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 43RD ST S STE 105",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033579",
            "telephone_number": "218-287-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGOLD",
        "first_name": "ANI",
        "middle_name": "CELINE",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "653",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "MANGOLD",
            "middle_name": "CELINE",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.