Allen James Irish-Zabolotny, LPC, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

863-1-15-16 Issued in ND

Practice address

4733 Amber Valley Pkwy S
Fargo, ND 58104-8647

Phone

(701) 220-9512

NPI assigned

Sep 11, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1104227925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4733 AMBER VALLEY PKWY S STE W",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581049073",
            "telephone_number": "701-401-6117",
            "fax_number": "701-540-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4733 AMBER VALLEY PKWY S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048647",
            "telephone_number": "701-220-9512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRISH-ZABOLOTNY",
        "first_name": "ALLEN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LPC, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-11",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "863-1-15-16",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "863-1-15-16",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Fargo, ND
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• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.