Active NPI
Elizabeth Nymberg
- Addiction (Substance Use Disorder) Counselor
- Fargo, ND
National Provider Identifier
1093309775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 901 28TH St S Ste C
Fargo, ND 58103-8745 - Phone
- (701) 404-1100
- NPI assigned
- Feb 23, 2021
- Last updated
- Feb 23, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | NU | Primary |
Addresses
Primary practice location
901 28TH St S Ste C
Fargo, ND 58103-8745
Mailing address
2015 Fall Dr Apt H
Wilmington, NC 28401-6877
Phone (910) 386-3438
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Unknown |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614038400000",
"number": "1093309775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2015 FALL DR APT H",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284016877",
"telephone_number": "910-386-3438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 28TH ST S STE C",
"city": "FARGO",
"state": "ND",
"postal_code": "581038745",
"telephone_number": "701-404-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYMBERG",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-23",
"last_updated": "2021-02-23",
"certification_date": "2021-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Unknown",
"affiliation": "N",
"address_1": "901 28th St S Ste C",
"city": "Fargo",
"state": "ND",
"country_code": "US",
"postal_code": "581038745",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.