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

Organization subpart

No

Name

Angela CollinsNPI 1871827329

Title

Owner

Phone

(701) 253-1550

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angela B Collins, PHD

  • Psychologist
  • Fargo, ND
  • NPI 1871827329

  ND, Psychologist

  Medicare reassignment NPD Authorized official
• Gillian Amanda Gervais Freeborn, PSYD

  • Clinical Psychologist
  • Fargo, ND
  • NPI 1780025932
  NPD (past)
• Samantha Oliver, PHD

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

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 18, 2023.

{
    "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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• All providers in Fargo, ND
• 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.