Amber D Nelson, LPCC, LCAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

787-6-1-14A Issued in ND

Practice address

7151 15TH St S
Fargo, ND 58104-6613

Phone

(701) 857-4232

Fax

(701) 852-1190

NPI assigned

Oct 28, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

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.

• Dakota Family Services

  • Clinic/Center
  • Fargo, ND
  • NPI 1578755344
  NPD (past)

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

{
    "created_epoch": "1382918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1154759223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 19TH AVE NW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587038899",
            "telephone_number": "701-857-4232",
            "fax_number": "701-852-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7151 15TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046613",
            "telephone_number": "701-857-4232",
            "fax_number": "701-852-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AMBER",
        "middle_name": "D",
        "credential": "LPCC, LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-28",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1695",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "787-6-1-14A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75025",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel K Nelles, FNP
• Matthew John Nelsen, MD
• Addy Nelson, LSW
• Alexander Ardian Nelson
• Alexandra N Nelson
• Andrew Brien Nelson, NP
• Angelique Kui Nelson, RN BSN
• Anica Yvonne Nelson, RBT
• Autumn Nelson
• Blair Allen Nelson, MD

• Professional Counselor in Fargo, ND
• Providers in Fargo, ND by specialty
• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.