Ac Psychological Services LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

AC PSYCHOLOGICAL SERVICES LLC

Practice address

112 University Dr N Ste 300
Fargo, ND 58102-4661

Phone

(701) 253-1550

Fax

(701) 299-4510

NPI assigned

May 18, 2023

Last updated

May 18, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela CollinsNPI 1871827329

Title

Owner

Phone

(701) 253-1550

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela B Collins, PHD

  • Psychologist
  • Fargo, ND
  • NPI 1871827329
  Medicare reassignment NPD Authorized official
• Gillian Amanda Gervais Freeborn, PSYD

  • Clinical Psychologist
  • Fargo, ND
  • NPI 1780025932
  NPD (past)
• Brandon Miller, PH.D.

  • Mental Health Counselor
  • West Fargo, ND
  • NPI 1699685263
  NPD (past)
• Samantha Oliver, PHD

  • Clinical Psychologist
  • Fargo, ND
  • NPI 1750923033
  NPD (past)

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1043901101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 UNIVERSITY DR N STE 300",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024661",
            "telephone_number": "701-253-1550",
            "fax_number": "701-299-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 UNIVERSITY DR N STE 300",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024661",
            "telephone_number": "701-253-1550",
            "fax_number": "701-299-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AC PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-253-1550"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Fargo, ND
• Providers in Fargo, ND by specialty
• Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.