Active NPI
Life Management Resources
- Clinical Social Worker
- Devils Lake, ND
National Provider Identifier
1104089648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 603
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Maryjane Blanchfield, LICSW
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19193 | Medicaid | ND |
National Provider Directory
National Provider DirectoryLocations
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.