Individual provider Active NPI

Cheryl Melbye, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Fargo, ND
National Provider Identifier
1083259824
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1870 Issued in ND
Practice address
510 4TH St S
Fargo, ND 58103-1914
Phone
(701) 476-7240
NPI assigned
Nov 15, 2019
Last updated
Nov 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1870 ND Primary

Addresses

Primary practice location

510 4TH St S
Fargo, ND 58103-1914

Mailing address

510 4TH St S
Fargo, ND 58103-1914
Phone (701) 476-7200

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
I20241113002518 ND Practitioner - Mental Health Counselor 4880128859 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1870NDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Behavioral Health Clinic CurrentSince Sep 6, 2024 Accepting new patients

Locations

600 E Boulevard Ave
Dept 325
Bismarck, ND 58505
Phone (701) 328-4644

2624 9th Ave SW
Fargo, ND 58103
Phone (701) 298-4500

Organizations & group practices 1

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1083259824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 4TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031914",
            "telephone_number": "701-476-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 4TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031914",
            "telephone_number": "701-476-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELBYE",
        "first_name": "CHERYL",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.