Organization Active NPI

Life Management Resources

  • Clinical Social Worker
  • Devils Lake, ND
National Provider Identifier
1104089648
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
603 Issued in ND
Legal business name
LIFE MANAGEMENT RESOURCES
Practice address
400 12TH Ave NE
Devils Lake, ND 58301-2712
Phone
(701) 665-5433
NPI assigned
Jul 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Maryjane Blanchfield, LICSWNPI 1881767960
Title
Ceo
Phone
(701) 665-5433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 603 ND Primary

Addresses

Primary practice location

400 12TH Ave NE
Devils Lake, ND 58301-2712

Mailing address

400 12TH Ave NE
Devils Lake, ND 58301-2712
Phone (701) 665-5433

Other identifiers 1

IdentifierTypeStateIssuer
19193MedicaidND

National Provider Directory

National Provider Directory

Locations

400 12th Ave NE
Devils Lake, ND 58301
Phone (701) 655-5433

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1104089648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 12TH AVE NE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012712",
            "telephone_number": "701-665-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 12TH AVE NE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012712",
            "telephone_number": "701-665-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE MANAGEMENT RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "BLANCHFIELD",
        "authorized_official_first_name": "MARYJANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-665-5433",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19193",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.