Amanda Havelange

Individual provider Active NPI Social Worker · Grand Forks, ND

NPI 1124677406 · NPPES record last updated Dec 27, 2024

Key facts

NPI
1124677406
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
5740 (ND)
Practice address
151 S 4TH St Ste 401
Grand Forks, ND 58201-4715
Phone
(701) 795-3000
NPI assigned
Sep 9, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Central Human Service Center (23 clinicians)
West Central Human Service Center (16 clinicians)
Badlands Human Service Center (18 clinicians)
Northeast Human Service Center (22 clinicians)
Lake Region Human Service Center (16 clinicians)
Northwest Human Service Center (12 clinicians)
South Central Human Service Center (23 clinicians)

Practice addresses (Care Compare)

1015 S Broadway
Suite 18
Minot, ND 58701-4667
Phone (701) 857-8500

1237 W Divide Ave
Suite 5
Bismarck, ND 58501-1208
Phone (701) 328-8888

1463 I94 Business Loop E
Dickinson, ND 58601-6434
Phone (701) 227-7500

151 S 4TH St
Suite 401
Grand Forks, ND 58201-4715
Phone (701) 795-3000

200 Hwy 2 W
Devils Lake, ND 58301-3532
Phone (701) 665-2200

316 2ND Ave W
Williston, ND 58801-5218
Phone (701) 774-4600

520 3Rd St NW
Jamestown, ND 58401-2968
Phone (701) 253-6300

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230522003152 ND Practitioner - Clinical Social Worker 9436515178 Reassigns benefits to 8 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Behavioral Health Clinic Current
since Sep 2, 2023
Accepting new patients
Lake Region Behavioral Health Clinic Current
since Sep 2, 2023
Accepting new patients
West Central Behavioral Health Clinic Current
since Sep 26, 2023
Accepting new patients
South Central Behavioral Health Clinic Current
since Sep 2, 2023
Accepting new patients
North Central Behavioral Health Clinic Current
since Nov 23, 2024
Accepting new patients
Northeast Human Service Center Current
since Sep 2, 2023
Accepting new patients
Badlands Behavioral Health Clinic Current
since Sep 2, 2023
Accepting new patients
Southeast Behavioral Health Clinic Current
since Jan 31, 2023
Accepting new patients
Northwest Behavioral Health Clinic Current
since Nov 23, 2024
Accepting new patients
Badlands Behavioral Health Clinic Past
since Sep 2, 2023
Accepting new patients

Locations

1237 W Divide Ave
Ste 5
Bismarck, ND 58501
Phone (701) 328-8888

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

200 Highway 2 W
Devils Lake, ND 58301
Phone (701) 665-2200

1463 I94 Business Loop E
Dickinson, ND 58601
Phone (701) 227-7500

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

151 S 4th St
Ste 401
Grand Forks, ND 58201
Phone (701) 795-3000

520 3rd St NW
Jamestown, ND 58401
Phone (701) 253-6300

1015 S Broadway
Ste 18
Minot, ND 58701
Phone (701) 857-8500

316 2nd Ave W
Williston, ND 58801
Phone (701) 774-4600

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 5740 ND Yes

Addresses

Primary practice location

151 S 4TH St Ste 401
Grand Forks, ND 58201-4715

Mailing address

2624 9TH Ave S
Fargo, ND 58103-2350
Phone (701) 298-4500

Other providers in Grand Forks, ND

All providers in Grand Forks, ND · Social Worker in North Dakota

Sources for this page

Verify at the official NPI Registry.