Jennifer Fetsch

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4437 Issued in ND

Practice address

1726 S Washington St Ste 33a
Grand Forks, ND 58201-6395

Phone

(701) 746-4584

NPI assigned

Jun 21, 2016

Sex

Female

Sole proprietor

No

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

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Village Family Service Center

  • Substance Abuse Rehabilitation Facility
  • Fargo, ND
  • NPI 1952679318
  NPD (past)

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1134579139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 S WASHINGTON ST STE 33A",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016395",
            "telephone_number": "701-746-4584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 S WASHINGTON ST STE 33A",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016395",
            "telephone_number": "701-746-4584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETSCH",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21660",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "4437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Fernandez Flores
• Kele Ferreira, PA-C
• Rhea J Ferry, FNP-C
• Donna Fertig, RN
• Isabell Fetsch, OTD, OTR/L
• Christina Fiebiger
• Steven George Finstrom, RPH
• Brent Firari, RN, SRNA
• Fire Audiological Services P.C.
• Kevin Michael Fire, PH.D.

• Clinical Social Worker in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.